N105: Essentials of Nursing Care - Health Differences

Essentials of Nursing Study Guide

©2017 Achieve Test Prep Page 42 of 160 This occurs when there is damage to the mucosal lining or brush border, which leads to a passive loss of protein-rich fluids, and a decreased ability to absorb these lost fluids. Features of the other types of diarrhea can be found in this type of diarrhea. It can be caused by bacterial infections, viral infections, parasitic infections, or autoimmune problems such as inflammatory bowel diseases. It can also be caused by tuberculosis, colon cancer, and enteritis. Generally, if there is blood visible in the stools, it is not diarrhea, but dysentery. The blood is trace of an invasion of bowel tissue. Dysentery is a symptomof, among others, Shigella, Entamoeba histolytica, and Salmonella. Flatulence Flatulence is caused by action of bacteria on the chyme in the large intestine, swallowed air, and gas that diffuses from the blood stream into the intestine. It is normal for humans to pass flatus per rectum, although the amount and the frequency may vary greatly between individuals. It is also normal for intestinal gas passed per rectum to have a characteristic feculant odor, although this too may vary in concentration. Flatus is brought to the rectum by specialized contractions of the muscles in the intestines and colon. The noises commonly associated with flatulence are caused by the vibration of the anal sphincter, and occasionally by the closed buttocks. Both the noise and odor associated with flatus leaving the anus can be sources of embarrassment or comedy. There are three general symptoms related to intestinal gas: pain, bloating, and abdominal distension. Bowel Incontinence Bowel Incontinence is a loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter. Partial incontinence is the inability to control flatus or client has minor soiling. Major incontinence is the inability to control feces of normal consistency. This is associated with impaired functioning of the anal sphincter or nerve supply. • Exudative diarrhea: This occurs with the presence of blood and pus in the stool. This is common with inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, and other severe infections such as E. coli or other forms of food poisoning. • Motility-related diarrhea: This is caused by the rapid movement of food through the intestines (hypermotility). If the food moves too quickly through the gastrointestinal tract, there is not enough time for sufficient nutrients and water to be absorbed. This can be due to a vagotomy or diabetic neuropathy, or a complication of menstruation. Hyperthyroidism can produce hypermotility and lead to pseudo diarrhea and occasionally real diarrhea. Diarrhea can be treated with antimotility agents (such as loperamide). Hypermotility can be observed in people who have had portions of their bowel removed, allowing less total time for absorption of nutrients. • Inflammatory diarrhea: