Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 47 of 160 • Stool softeners: These use moistening agents and are best used in anticipation of constipation. Example is Colace (docusate sodium). This method takes several days to get started. • Isotonic laxatives: These are normal saline, which work by stimulating peristalsis. This is the safest solution touse. Laxatives are contraindicated in intestinal obstruction, inflammations (typhoid fever, ulcerative colitis), hemorrhage, and intussusception, as well as to rule out appendicitis. Nursing Procedures • Bowel training programs : based on factors within the client’s control, designed to help the client establish normal defecation; assessment for training includes determining normal bowel habits, designing a plan that includes fluid intake of 2500-3000ml per day, an increase in fiber, an intake of hot drinks and increased exercise • Evaluation: record and report patient’s response to nursing actions; clients should report that defecation is comfortable, without cramping, distention, or pain; document increased fluid intake, altered consistency of stool, increased volume of urine, or adverse reactions to treatments; reassess and revise patient’s plan of care; change pattern of patient’s fluid intake to control enuresis; use of fracture pan rather than a regular bedpan; provide bedside commode • Diagnostic data: study stool for ova and parasites; normal stool contains bacteria and fungi; some common bacteria found in stool are salmonella, Shigella, E. coli, and staph; common parasites are hookworms, tapeworm and protozoa (Giardia) • Stool culture : ova and parasites are collected over a series of time; check stool for occult blood; the guaiac test can be readily performed by the nurse or the client at his/her home using a minute amount of stool; strict aseptic technique must be usedwhen collecting or testing stool specimens or any blood or body fluids for the presence of bacteria or viruses • Occult blood : used to determine the presence of blood in stool; this is called a hem occult test where a small smear of stool is placed on the slide or card, which is then closed and turned over so that a reagent can be dropped onto the smear and is observed for a blue color, a positive result; certain foods, medications, and vitamin C can cause inaccurate results; false positives can occur from eating red meat, raw fruits or vegetables, or taking certain medications that cause GI bleeding such as ASA and NSAIDS; vitamin C can cause a false negative, if taken up to three days prior to testing