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Module 7: Bowel Elimination

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MOD7 Bowel EliminationSeptember2410203 PMDescribe the process involved in ingestion digestion absorption and elimination 1Ingestionis the intake of food via the mechanical component of swallowing deglutition The organs involved for ingestion are the mouth the pharynx and the esophagus In the mouth food is masticated chewed and the tongue assists in chewing by keeping food between the teeth during this process The tongue also moves food to the back of the throat for swallowing During ingestion the oropharynx provides a route for food to get from the mouth to the esophagus The epiglottis prevents food from entering the larynx Once in the esophagus food is moved by means of peristalsis contraction and relaxation which propels food toward the stomachDigestioninvolves both mechanical mastication and chemical breakdown of food into absorbable substances Saliva in the mouth consists of salivary amylase which hydrolyzes starches to maltose In the stomach digestion of proteins begins with the release of pepsinogen into pepsin due to low pH level from chief cells Pepsin breaks down proteins Digestive juices and gastric secretions mix with the food to further break it down The small intestine also aids in digestion as the folds in the mucosa slow food down and provides a greater surface for digestion Carbohydrates are hydrolyzed into monosaccharides here and fats to glycerol and fatty acids Proteins become amino acidsAbsorptionis the uptake of nutrients from the gut lumen to the bloodstream It is the transfer of the end products of digestion across the intestinal wall to the circulation Most of this process happens in the small intestine due to the surface area provided by the circular folds villi and microvilli Water and electrolytes are primarily absorbed in the large intestineEliminationtakes place in the large intestine The large intestine secretes mucus which acts as a lubricant to protect the mucosa Propulsive mass movements peristalsis occurs to move feces along the intestines and is a kneading action haustral churning Defecation is the discharge of feces from the rectum and is a reflex action that can be voluntary and involuntary Feces in the rectum stimulate sensory nerve endings that produce the desire to defecate via the sacral portion of the spinal cord parasympathetic nerve fibres Defecation is controlled voluntarily by relaxing the external anal sphincter when the desire is felt Describe the assessment physicaldiagnostic planning interventions evaluation and documentation of care 2to meet the needs of diverse clients with normal and abnormal eliminationAssessment includes a nursing health history a physical assessment of the abdomen inspection of fecal characteristics and a review of relevant test results Also the nurse needs to determine the clients medical history pattern and types of fluid and food intake chewing ability medications and recent illnesses and stressorsHealth History provides a review of the clients usual bowel patterns and habits Much of the nursing health history can be organized around the factors that affect bowel eliminationDetermination of the clients usual bowel elimination patternaThe clients description of the usual stool characteristicsbIdentification of routines followed to promote normal bowel eliminationcAssessment of the use of artificial aids at homedAssessment of cognitive capacityePresence and status of bowel diversionsfChanges in appetitegDiet historyhDescription of daily food intakeiHistory of surgery or illnesses affecting the GI tractjMedication historykEmotional statelHistory of exercisemHistory of paindiscomfortnSocial historyoMobility and dexteritypPhysical assessment evaluates a clients body systemsfunctions that are likely to be affect by the presence of bowel elimination problemsMouth includes teeth tonguegumsaAbdomen inspect all 4 quadrants for contour shape symmetry and skin colourb NSE22 Page 1
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