1. Nursing B20- Fundamentals of Nursing
Bowel Elimination
Nursing B20-
Fundamentals of Nursing

2. Psychological/ Physiological Factors Affecting Elimination
Age and developmental factors
Dietary intake
Fluid intake
Physical activity
Psychological factors
Personal elimination habits

3. Psychological/ Physiological Factors Affecting Elimination (contd)
Position during defecation
Pain
Pregnancy
General anesthesia
Medications
Diagnostic GI tests

4. Common Bowel Elimination Problems
Constipation
Fecal Impaction
Diarrhea
Incontinence
Flatulence
Hemorrhoids

5. Bowel Diversions Three types of colostomies Ileostomy Loop Colostomy
End Colostomy
Double-Barrel Colostomy
Ileostomy

6. Bowel Diversions
Single (End) Colostomy

7. Bowel Diversions
Loop Colostomy

8. Bowel Diversions
Double Barrel Colostomy

9. Bowel Diversions

10. Assessment of Bowel Function
Nursing History
Physical Assessment
Fecal Characteristics
Laboratory/ Diagnostic Tests
Fecal specimens
Guaiac test
Diagnostic tests
Direct visualization
Indirect visualization

11. Nursing Diagnosis Constipation Diarrhea Bowel Incontinence Pain
Self-Care Deficit- Toileting
Body Image Disturbance
Risk for/ Impaired Skin Integrity

12. Plan and Implementation
Promotion of regular bowel habits
Promotion of normal defecation
Digital removal of stool
Maintenance of proper fluid/ food intake
Promotion of regular exercise
Promotion of comfort

13. Plan and Implementation (continued)
Use of enemas
Cleansing enemas
Tap water- hypotonic
Normal saline- isotonic
Fleets- hypertonic
Soap Suds- intestinal irritation
Oil Retention enemas
Carminative
Return flow or Harris flush
Medicated

14. Plan and Implementation (continued)
Care of Ostomies
Pouching of Ostomies

15. Plan and Implementation (continued)
Irrigating an ostomy