CHAPTER

TRUE OR FALSE Vie lek Feces become hard and dry when
fluid intake is poor.
Circle T for true, or circle F for false.
12 lee The support worker may help
1. TF Feces move through the intestine by to prevent fecal incontinence by
a process called defecation. promptly responding to all requests
for help using the bathroom,
2. TF Constipation is a condition in which
bedpan, or commode.
c bowel movements are less frequent
than usual. 1320 lr One of two goals of bowel training
is to develop a regular pattern of
3. TF Support workers are not responsible
elimination, thus preventing fecal
for the promotion of a normal bowel
impaction, constipation, and fecal
routine for clients.
incontinence.
4. T F Fewer than 10 wet diapers per
14. T F When you are helping a client
day from an infant may indicate
with bowel training, the client is
dehydration.
usually encouraged to use the toilet,
5. TF Enemas can be dangerous. commode, or bedpan before a meal.

6. F A support worker is allowed to insert Wieme 1h) Fe A suppository is used to stimulate

rectal tubes to relieve flatulence. defecation when bowel training is
being done.
rie F A stoma is painful when touched.
16; 0" 4F Giving an enema is a controlled act.
8. F Aclient with an ostomy pouch can
wear normal clothes.
Wie de ae Enemas may be ordered by the
designated health care provider to
9. T F When internal bleeding is suspected, prepare the client for certain X-ray
feces are checked for blood. procedures.

10. T EF Acommercial enema stimulates and teh de Ly ‘The volume of saline enema varies
distends the rectum. according to a child’s size and age.
172 CHAPTER 30. Bowel Elimination

19. TF The purpose of an ostomy pouch is : 26. What are common causes of constipation?
to collect feces and flatus. A. A high-fibre diet
B. Ignoring the urge to defecate
20 T F An ostomy bag is changed every day C. Decreased fluid intake
and whenever it leaks. D. Activity
E. Medications
21 T F An ostomy pouch can be removed E Aging
and changed when peristalsis is less Gx SGerednediseases
active. The best time is usually after
breakfast. 27. Which of the following comfort and safety
measures can the support worker use when
22 T F Fore from oe ileostomy is especially assisting a client with fecal elimination?
irritating to the skin because the A. Assist the client to the toilet or
small intestine contains digestive commode, or provide the bedpan, as
juices that are very irritating. soon as requested.
B. Provide fe i k visitors to leave
23. TF Occult blood is bright red blood that fevice (oe eee et eae
‘ ; the room, close doors, pull privacy
can be easily observed in the stool. ; :
curtains, and close window curtains,
blinds, or shades).
MULTIPLE RESPONSE C. Make sure the bedpan is cold.
; D. Position the client in a side-lying position.
From the list below, choose all of the correct B. Allow enough ameter tetesicn sida
answers.
not rush the client.
24. What should you observe and report when a F Place the call bell and toilet tissue
within reach.
client has a bowel movement? eH3. .
wee. G. Leave the room if the client is weak or
A. Abnormalities in colour 4
B. Abnormalities in amount SS
saan ; H. Provide oral care.
C. Abnormalities in consistency :
D.
bash
Abnormalities in odour
I. Dispose of stool
;
promptly.
Da Droeralines crac iE fo the client with hand hygiene after
FE. Abnormalities in size baa uae ae
. Phautel a Heavens 28. What symptoms may occur if flatulence is
H. Complaints of pain :
not relieved?
25. What are some signs of fecal impaction? A. Abdominal cramping or pain
? ‘ B. Shortness of breath
A. Abdominal discomfort and swelling
B./ Cramping C. Decreased level of consciousness
C. A feeling of fullness or pain in the D. Swollen abdomen, or “bloating
rectum ae ,
29. Which of the following are reasons that
D. Nausea or vomiting ene
enemas are given?
Eg) Hever
Ny A. To remove feces
FE Increased need or decreased ability to ; mde
B. ‘To relieve constipation or fecal impaction
urinate ;
G. Liquid feces seeping from the anus Cailtlo sn coutsecieteutos
Spee Pins D. To clean the bowel of feces before
H. Regular bowel movements é
certain surgeries or X-ray procedures
E. To relieve flatulence and intestinal
distension

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 CHAPTER 30. Bowel Elimination 173

30. How can odour associated with an ostomy 34. Which of these may kill normal flora in the
pouch be prevented? intestine?
A. By providing good hygiene A. Antibiotics
B. Instructing the client to cover it with a B. Laxatives
plastic bag C. Pain medications
C. By encouraging the client to avoid gas- D. Enemas
forming foods
D. By putting deodorants into the pouch, 35. What instruction will the nurse likely give if
according to the care plan a client has diarrhea or loose stools?
A. Withhold all fluids
B. Give the client plenty to drink
MULTIPLE CHOICE C. Encourage the client to eat as little as
Circle the correct answer. possible
D. Give the client foods with plenty of
31. Which of the following will not assist fecal fibre
elimination?
A. Drinking a hot beverage 36. What would be an effective nursing action to
B. Using a bedside commode in a relieve flatulence?
semiprivate room A. Giving an enema
C. Taking a walk B. Making sure the diet is high in
D. Reading a book or newspaper vegetables
C. Having the client lie flat in bed
32. Which of these foods would be most likely to D. Ambulating the client or placing the
- stimulate fecal elimination? client in the side-lying position
A. Pudding and gelatin
B. Whole-grain cereals and fruit 7. When the nurse or support worker
C. Meat and fish (where allowed by agency policy) inserts
D. Pretzels and potato chips a suppository into a client’s rectum to
stimulate defecation, how soon would you
33. Mr. Leroux, 85, usually has a bowel expect results?
movement after breakfast. About 45 minutes A. In about 30 minutes
after having a bowel movement, he wants to B. Immediately
go to the bathroom again. The most likely Cieeln2aos bouts
reason for this is: D. In the morning
A. Older persons lose control over
defecation. 38. Which position is best when giving an
B. Complete emptying of the rectum does enema?
not always occur with older persons. A. Sims’ position
C. He may have a tumour or other B. Right position
disorder. C. Semi-Fowler’s position
D. He is concerned about becoming D. Prone position
constipated.

Copyright © 2022 Elsevier Inc. All rights reserved.

174 CHAPTER 30. Bowel Elimination

39. Which of the following statements about f 42. What is the purpose of a rectal tube?
stool specimens is correct? A. Relief of constipation
A. Stool specimens are best obtained at the B. ‘Treatment of fecal impaction
end of the day. C. Prevention of diarrhea
B. Urine will contaminate the stool D. Relief of flatulence and distension
specimen.
C. Stool specimens should be sent to the 43. What is the consistency of the stool if
lab by the end of each shift. a colostomy is near the end of the large
D. Stool specimens that contain blood intestine?
have been contaminated and should not A. Liquid
be accepted. B. Soft
C. Formed
40. You should wear gloves when testing a stool D. Hard and dry
for occult blood to:
A. Prevent contact with body fluids and 44, Which of these methods would help to
substances prevent skin breakdown around the stoma?
B. Prevent contaminating the specimen A. Clean with alcohol wipes
C. Maintain a sterile specimen B. Use an antiseptic lotion or petroleum
D. Prevent contact with chemicals used in jelly on the skin
the test C. Clean the area with water and mild
soap as directed by the nurse
41. The term melena describes stool that: D. Wipe with tissues until clean
A. Is black and tarry
B. Contains unseen blood
C. Hard and pebble-shaped
D. Contains visible parasites

MATCHING
Match each of the corresponding factors that can cause the stool to change colours to the correct colour.

45. Bleeding in the stomach A. Green

46. Bleeding in the lower colon or rectum; also, beets B. Black

47. A diet high in green vegetables Gun Red

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 CHAPTER 30. BowelElimination 175

Match each definition to the correct word.

48. Semi-solid mass of waste products in the colon A. Defecation

49. Introduction of fluid into the rectum and lower colon B. Suppository

50. ___ Artificial opening between the ileum and abdomen C. Diarrhea

“ae Bowel movement D. Peristalsis

ye Alternating contraction and relaxation of intestinal muscles Ey eeces

53. Surgical creation of an artificial opening E Ostomy

54. Cone-shaped medication that is inserted into a body opening G. Enema

Boe Gas or air in the stomach or intestines Eiee Cyne

56. Feces that have been excreted I. Flatus

a7« Frequent passage of liquid stools J. Stoma

58. Partially digested food and fluids that pass from the stomach to K. Stool
the small intestine

Enh The opening of a colostomy or ileostomy L. Tleostomy

FILL IN THE BLANKS

60. What effect does normal bacterial action in the large intestine have on the stool?

61. What are the risks if you do not give good skin care to a client who has loose stools or diarrhea?
a.
b:
Cc.

62. How would you mix the solution for a saline enema?

63. How does a commercial enema, which contains only 120 mL of solution, stimulate defecation?

64. When you are giving “enemas until clear,” how will you know that you have given enough?

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176 CHAPTER 30. Bowel Elimination
oniiyinieienscuinsencsinealWitotimnorasn
ineEABNEAHOEREOAAINER

65. How warm is the solution in a cleansing enema? ee

66. Only a enema may be given to children.

67. What instructions should you give to a client who is going to expel an enema in the toilet?

68. What will happen if you release pressure on a commercial enema container while giving an enema?

69. What is the purpose of an ostomy pouch?

70. You should empty or open an ostomy pouch when or when the
bag

lee An ostomy bag is changed every days.

Tea An ostomy pouch can be removed and changed when peristalsis is less active. The best time is usually

Hgos Why are certain stool specimens taken directly to the laboratory?

Refer to the figure when answering Questions

74-76:

74. a. How high above the anus should the bag

hang? emma ns
b. How high above the mattress should bag
hang?

75. How far should the tube be inserted into the

rectum?

76. Identify the position of the person.

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 CHAPTER 30 Bowel Elimination 177.

WORD SEARCH 83. Cone-shaped

medication that is inserted into a body
Write the correct word next to each definition opening
below. Then find those words in the Word Search
and circle or highlight them in the word search 84. Gas or air in the
puzzle. stomach or intestines

re Semi-solid mass of 85. Feces that have

waste products in the colon been excreted

78. Introduction of 86. Frequent passage of

fluid into the rectum and lower colon liquid stools

79. Artificial opening 87. Partially digested

between the ileum and abdomen food and fluids that pass from the stomach
to the small intestine
80. Bowel movement
88. The opening of a
81. Alternating contraction colostomy or ileostomy
and relaxation of intestinal muscles

82. Surgical creation of

an artificial opening

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