Laxatives
laxative most similar to dietary fiber
Psyllium
group III - bulk forming laxative (increases intestinal volume)
when might you need to use a rectal suppository?
when oral route is not effective/not an option (NPO, NV, dysphagia)
what are the three types of enemas
cleansing
retention
large volume
reasons for a rectal tube
instill meds
relieve gas
collect liquid BM due to skin integrity concerns
TRUE OR FALSE: placement of ostomy determines general stool consistency?
TRUE
how does polyethylene glycol (miralax) work?
osmotic action draws water into intestinal lumen
[Group II - osmotic laxative)
TRUE OR FALSE: you should use lubricant when inserting a rectal suppository?
TRUE
how many large volume enemas/day is the limit
3
focused assessment for a pt with rectal tube
ABDOMINAL
SKIN
what should the stoma look like
dark pink to red, moist
what laxative has a high abuse potential?
Bisacodyl/Senna
Group II - stimulant laxative
what position should your pt be in for a rectal suppository?
left side lying, knees pulled in
most common reason for an enema
fecal impaction
pt instructions during digital removal of stool
deep breaths, bear down
when should the ostomy bag be emptied?
1/3 full
Side effects of Milk of Magnesia
- abdominal cramping
- diarrhea, dehydration
- hypomagnesaemia
common uses for rectal suppositories
- to promote fecal elimination
- to treat NV
- to treat fever
- to treat pain
- aspirin to prevent DVT
what controls the "flow rate" of a large volume enema
height of administration bag
adverse effect of digital removal
vagus nerve stimulation -
watch for drop in HR
what are some concerns with a new ostomy?
psychosocial: self-image, coping
ability to care for self
risk for infection
what class is Docusate Sodium (colace)
Group II - emollient laxative
(allows water and fat to penetrate into stool)
TRUE OR FALSE: suppositories can melt in your hand if you hold onto them for too long before needing to use them
TRUE - they melt at body temp
adverse effects associated with enema procedure
assess for: dizziness, lightheadedness, nausea, diaphoresis, and clammy skin
monitor BP and pulse if this occurs
nursing diagnosis for a pt with a rectal tube
at risk for/impaired elimination
at risk for /fluid volume imbalance (hypovolemic)
at risk for/skin breakdown
TRUE OR FALSE: skin around stoma is at high risk for infection and maceration?
TRUE