Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 39 of 160 are dark or black, indicative of upper GI bleeding, use of certain drugs or medications, or ingestion of large amounts of dark green vegetables (collards or spinach). Consistency should be slightly formed and semisolid without dryness or diarrhea. Shape is cylindrical; very narrow stool is indicative of an obstructive process in the rectum, such as hemorrhoids. Odor is pungent and affected by ingested foods and spices. Stool should not contain pus, blood, large amounts of fat or foreign objects. Elimination throughout Life Stages Some control of defecation starts at 1 ½ - 2 years of age. Patterns vary in frequency, quantity and consistency. • Newborns and infants: Meconium is the first fecal material passed by the newborn. Infants pass stool frequently after each feeding. The intestine of an infant is immature and water is not well absorbed. • Toddlers: Toddlers can begin to control defecation at approximately two years of age. • School-age children: Children have similar bowel habits of an adult, but may delay defecation because of an activity. • Older adults: Older adults may often complain of constipation as a common problem. If this occurs, clients need to increase water to 6-8 glasses a day and increase fiber in the diet. Educate clients that consistent use of laxatives inhibits natural defecation reflexes and is thought to cause, rather than cure constipation. Additional Factors that Affect Elimination • Diet : Sufficient bulk in the diet is necessary to provide fecal volume. Spicy foods can produce diarrhea and flatus in some individuals. Excessive sugar can also cause diarrhea. Gas producing foods include: cabbage, onions, bananas, and apples. Laxative-producing foods can reveal generalized or localized areas of tenderness, mobile or fixed masses, muscle tightness, guarding and pain; palpate the bladder above the pubic symphysis for distention and masses • Assess the location, onset, sequence and chronology of abdominal pain; discuss description, frequency, and associated symptoms such as nausea, vomiting, and diarrhea; assess bowel habits; assess incidence of constipation or diarrhea; discuss change in appetite, food intolerances, and foods ingested in last twenty four hours; assess client’s specific signs and symptoms such as heartburn, flatulence, belching, difficulty swallowing, and blood or mucus in stools 2.2 Fecal Elimination Normal feces are brown in color. In breast fed infants the color is yellow. The color of stool varies depending on diet and the supply of bile; pale stools indicate lack of bile or malabsorption of fats. Abnormal feces