Lecture on Elimination

Introduction

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Key Points on Elimination and Aging

1. Aging and Bowel Elimination
   • Changes in the body lead to increased constipation risk
   • Decreased thirst = less fluid intake
   • Less efficient mastication (chewing)
   • Decreased salivation
2. Common Misconceptions:
   • Absorptive processes decrease, not increase
   • Esophageal emptying is delayed due to decreased motility
   • Changes in nerve innervation and sensation cause constipation, not diarrhea

Infant Severe Diarrhea: Major Concerns

• Major issue: Electrolyte and fluid loss
• Physiological integrity and Maslow's hierarchy: prioritize hydration & vital signs

Stool Test for Occult Blood

Correct Procedure:

• Only a one inch sample of formed stool is needed

Misconceptions:

• No sterile technique required, just clean
• Not a 3-day collection except for fecal fat
• Doesn't need to be kept warm unless testing for ova/parasites

Colostomy Post-Surgery Diet

• Initial diet: Poached eggs and rice
• Avoid high fiber foods (vegetables, fresh fruits, whole grains) to rest the GI tract

Biliary Disease and Stool Color

• Stool appears white or clay colored due to lack of bile
• Other options (bloody, pus-filled, black/tarry) indicate different conditions

Bulk-forming Foods

Good Choices:

• Whole grains

Misleading Options:

• Fruit juices, rare meats, milk products don't add bulk to stool

Medications to Promote Defecation

Key Teaching Points:

• Emollient solutions can increase water in the bowel
• Misconceptions:
  • Laxatives cause hypokalemia (not hyperkalemia)
  • Bulk-forming additives do not turn urine pink

Enema Procedure for Abdominal Cramping

• Solution: Lower the height of the enema container
• Misguided Actions: Do not stop infusion, advance tubing, or clamp it unnecessarily

Post-Op Clients and General Anesthesia

• Risk: Paralytic ileus (peristalsis stops transiently, takes 24-48 hours to resume)

Hypocalcemia and Constipation

• Implement measures to prevent: Constipation
• Symptoms: Muscle cramps, tetany, paresthesias

K-Excellate Enema

• Purpose: Remove excess potassium from the system
• Key association: Potassium (K) binding = important for electrolyte management

Enema Fluid Amount for School Age Child

• Appropriate volume: 300-500 ml
• Misleading amounts: Different volumes for infants, toddlers, adolescents

NG Tube Nursing Interventions

Correct Action:

• Mark tube where it exits the nose

Misguided Actions:

• Do not tape around the ear
• Do not secure tubing to the bed
• Do not change tubing daily

Safe Foods for Fecal Occult Blood Test

• Safe option: Whole wheat bread
• Unsafe choices: T-bone steak, veal, salmon (can cause false positives)

Arteriosclerosis and GI System Effects

• Accurate statement: Issues with blood flow affect bowel elimination
• Detailed reasoning over generalized statements

Role of Fiber in Bowel Patterns

• Correct perspective: Whole grain cereals and toast help regular bowel movement
• Common theme: High fiber foods promote peristalsis and decrease constipation risk

Conclusion

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