Question

a) What hygienic care should occur for patients with urinary catheters?

b) List the factors affecting bowel functioning.
c)  What are the characteristics of stool the nurse makes note of when assessing stool?

d) Describe the causes for the following types of abnormal stools: clay-coloured; black,
tarry; red; green; pus.
e) What instructions would the nurse give to a patient when it is necessary to collect a stool
specimen for analysis?
f) What aids are available to assist clients to eliminate when they cannot use a bathroom?
Describe when each would use.
g) Identify the types of fecal and urinary diversions. (ostomies)
h) Explain the differences in color and consistency of effluent based on the type of ostomy.
I) Describe methods used to maintain the integrity of the peristomal skin.

Answer 1

Ans)a) Care of patient with urinary catheter:

- Provide daily cleansing of the urethral meatus with soap and water or perineal cleanser, following agency policy.

- Ensure a closed drainage system.

- Ensure that no kinks or blockages occur in the tubing.

- Secure the catheter tube to prevent urethral damage.

b) Bowel elimination is the way your body rids itself of solid wastes. It can be influenced by lifestyle factors including diet, fluid intake, and physical activity. It can also be influenced by psychological factors and habits as well as age, pregnancy, and the presence of pain.

c) Inspect feces for color, odor, and consistency after the rectal exam or after defecation. Both hands are gloved.
COLOR
■ Blood on the stool results from bleeding from the sigmoid colon, anus, or rectum. Blood within the stool indicates bleeding from the colon due to ulcerative colitis, diverticulosis, or tumors. Black, tarry stools, called melena, occur with upper gastrointestinal bleeding. Oral iron may turn stools black and mask melena.
■ Grayish or whitish stools can result from biliary tract obstruction due to lack of bile in stool.
■ Greasy, frothy, yellow stools, called steatorrhea, may appear with fat malabsorption.
ODOR
■ Distinct, foul odors may be noted with stools containing blood or extra fat or in cases of colon cancer.
CONSISTENCY
■ Hard stools or long, flat stools may result from a spastic colon or bowel obstruction due to a tumor or hemorrhoids. Hard stools may also result from ingestion of oral iron.
■ Mucousy, slimy feces may indicate inflammation and occur in irritable bowel syndrome.
■ Watery, diarrhea stools appear with malabsorption problems, irritable bowel syndrome, emotional or psychologic stress, in-
gestion of spoiled foods, or lactose intolerance.

d) Red colour- Blood on the stool results from bleeding from the sigmoid colon, anus, or rectum. Blood within the stool indicates bleeding from the colon due to ulcerative colitis, diverticulosis, or tumors. Black, tarry stools, called melena, occur with upper gastrointestinal bleeding. Oral iron may turn stools black and mask melena.
■ Grayish or whitish stools can result from biliary tract obstruction due to lack of bile in stool.
■ Greasy, frothy, yellow stools, called steatorrhea, may appear pwith fat malabsorption.

When stool has visible mucus, it can be a sign of bacterial infections, anal fissures, a bowel obstruction, or Crohn's disease.