Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 38 of 160 for absorption into the blood. Although this source of vitamins, in general, provides only a small part of the daily requirement, it makes a significant contribution when dietary vitamin intake is low. An individual that depends on absorption of vitamins formed by bacteria in the large intestine may become vitamin deficient if treated with antibiotics that inhibit other species of bacteria as well as the disease-causing bacteria. Other bacterial products include gas (flatus), which is a mixture of nitrogen and carbon dioxide, with small amounts of the gases hydrogen, methane, and hydrogen sulphide. Bacterial fermentation of undigested polysaccharides produces these. The normal flora is also essential in the development of certain tissues, including the cecum and lymphatic. They are also involved in the production of cross- reactive antibodies . These are antibodies produced by the immune system against the normal flora, which are also effective against related pathogens, thereby preventing infection or invasion. The most prevalent bacteria are the bactericides , which have been implicated in the initiation of colitis and colon cancer. Bifidobacteria are also abundant, and are often described as friendly bacteria. A mucus layer protects the large intestine from attacks from colonic commensal bacteria. The large intestine is about 4.9 feet (1.5 m) long, which is about one-fifth of the whole length of the intestinal canal. Types of Movement in the Large Intestine Within the large intestines there are three main types of movements: • Haustral churning or shuffling is movement of the chyme back and forth within the haustra. This mixes the contents, aids in the absorption of water, and moves the contents forward. • Peristalsis is a wavelike movement that propels the intestinal contentsforward. • Mass peristalsis is a wave of powerful muscular contractions that moves over large areas of the colon. Nursing Procedures • Inspect the abdomen, skin integrity, rash or other lesions, contour and symmetry; assess for distention, obesity, ascites, or tumors; assess abdominal movement (is there limited movement related to pain or disease process); assess for visible peristalsis and marked aortic pulsations; assess for vascular pattern such as visible venous pattern (dilated veins) associated with liver disease, ascites and venocaval obstruction • Auscultate for bowel and vascular sounds (absent, hypoactive, hyperactive bowel sounds); auscultate for a loud bruit over the aortic area or a bruit over renal, iliac or femoral arteries • Percuss several areas in each of the four quadrants; tympany is gas in the stomach and intestines; dullness is a decrease, absence or flatness of resonance heard over solid masses or fluid; percuss the liver to determine its size • Palpate the abdomen last; light palpation can demonstrate tenderness, hypersensitivity, superficial masses, and localized areas of increased tension or tenderness; deep palpation