1. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE NUA 101 – CERTIFIED NURSE AIDE HEALTH CARE SKILLS UNIT 27 GASTROINTESTINAL ELIMINATION

2. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT OBJECTIVES Spell and define terms Describe aging changes of gastrointestinal system Describe some common disorders of gastrointestinal system Describe NA actions related to care of patients with disorders of gastrointestinal system List signs and symptoms NA should observe and report

3. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT INTRODUCTION Digestive tract extends from mouth to anus Receives help from teeth, tongue, salivary glands, liver, gallbladder, and pancreas in breaking down food into simpler substances Substances are used by body cells to carry on work of supplying nutrition and eliminating wastes

4. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT DIGESTIVE CHANGES WITH AGE Colon slows down, causing:  Food to remain in stomach longer  Slower food absorption  Slower elimination Taste buds lost Saliva production decreases Gag reflex less effective Fewer digestive enzymes  Resulting in indigestion and slower absorption of fat Constipation

5. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT COMMON DIGESTIVE DISORDERS Ulcers Ulcerative colitis Gastroesophageal reflux disease (GERD) Hernias

6. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT COMMON CONDITIONS Cholecystitis Cholelithiasis Constipation Fecal impaction Diarrhea Diverticulitis

7. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT COMMON PROBLEMS RELATED TO THE LOWER BOWEL Frequency of bowel elimination varies among individuals Some people have more than one bowel movement (BM) a day  Others have BM every two or three days BM usually soft and formed If BM passes through colon too quickly, loose and watery in consistency Diarrhea  Multiple watery stools If BM passes through colon too slowly, hard, dry, or sticky and pasty in consistency  Constipation

8. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT COMMON PROBLEMS RELATED TO THE LOWER BOWEL Fecal material normally brown  Color can be affected by certain foods, medications, and diseases Abdominal distention  Occurs when abdomen enlarges and appears bloated  Usually occurs as result of flatus (gas)  Are other causes Fecal impaction  Most serious form of constipation  Caused by retention of stool in rectum where water is absorbed Rectal prolapse  Large portion of rectum protrudes from body

9. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT COMMON PROBLEMS RELATED TO THE LOWER BOWEL Over time, stool becomes hard and dry  Patient cannot pass it Dried waste irritates bowel Mucus dissolves hard, outer part of mass

10. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT NURSE AIDE RESPONSIBILITIES WITH BOWEL CARE Monitor bowel elimination and report irregularities Record bowel movements on flow sheet If the patient is independent with bowel elimination, ask if had BM each day Report the following to nurse:  Frequent stools  Absence of stools  Pain  Cramping  Excessive flatulence

11. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT NURSE AIDE RESPONSIBILITIES WITH BOWEL CARE Report the following to nurse:  Abnormal color or consistency of stool  Extremely small amounts of stool  Hard, dry stool  Enlargement of abdomen Save abnormal stools for nurse to assess Report the following stool abnormalities:

12. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT NURSE AIDE RESPONSIBILITIES WITH BOWEL CARE Report the following stool abnormalities:  Blood  Pus  Mucus  Black or other unusual color  Undigested food  Except corn and raisins  Presence of parasites

13. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT ENEMAS Cleansing enema  Introduces fluid into rectum to remove feces and flatus from colon and rectum Avoid giving enema within an hour after meals  Increases peristalsis  Making it difficult for the patient to retain solution Avoid administering enema to the patient in sitting position. Solution will not flow into colon  Causes rectum to enlarge  Causing rapid expulsion of fluid

14. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT RECTAL TUBE AND FLATUS BAG Used to enable gas in bowel to escape  Use once every 24 hours for 20 minutes

15. CHEO PROJECT RED ROCKS COMMUNITY COLLEGE CHEO PROJECT OSTOMIES Ostomy  Surgical removal of a section of diseased bowel  Creates artificial opening in abdominal wall for elimination of solid waste and flatus  Appliance contains waste products  Skin irritation is great risk