N105: Essentials of Nursing Care - Health Differences

Essentials of Nursing Study Guide

Consequences of Fecal Incontinence Fecal incontinence can cause additional problems, including: • The possible development of secondary conditions, (skin maceration, urinary tract infections, or decubitus ulcers). • Financial expense for patients (related to diapers and clothes), employers (days off and loss of productivity), and medical insurance (health care cost and unemployment). • Decreased quality of life (self-esteem, embarrassment, shame, depression, need to organize life around easy access to bathroom, avoidance of enjoyable activities). Involuntary excretion and leaking are common occurrences for those affected. Subjects relating to defecation are often considered a social taboo, thus those affected may be beset by feelings of shame and humiliation. Some do not seek medical help and instead attempt to self-manage the problem. This can lead to social withdrawal and isolation, which can turn into cases of agoraphobia. Such effects may be reduced by undergoing prescribed treatment, taking prescribed medicine, and making dietary changes. 2.4 Bowel Diversion Ostomies An ostomy is an opening on the abdominal wall for the elimination of feces or urine. Gastrostomy is an opening through the abdominal wall into the stomach. Jejunostomy is an opening through the abdominal wall into the jejunum. Ileostomy is an opening into the ileum (small bowel). Colostomy is an opening into the colon (large bowel). Ureterostomy is an opening into the ureter. Temporary colostomies are performed for traumatic injuries or inflammatory conditions of the bowel. Permanent colostomies are used when the rectum or anus is nonfunctional as result of birth defect or disease, such as cancer of the bowel. Anatomic Location of the Ostomy An ileostomy produces constant liquid fecal drainage. It contains digestive enzymes which are damaging to the skin. Odor is minimal because few bacteria are present.

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