Essay Example on Bowel Elimination Concerns: Constipation, Impaction, Diarrhea, & More

Introduction

Bowel elimination is described as the fundamental bodily function of expelling feces from the body. There are different bowel elimination concerns, and these include constipation, impaction, diarrhea, flatulence, incontinence, and hemorrhoids. Constipation is not a disease but a symptom in which there is difficulty in eliminating infrequent stool. It is caused by different factors such as diet, medications, and decreased fluids, among others (Pellatt, 2013). Another concern is impaction, which is due to unrelieved constipation due to hardened feces accumulated in the rectum. It is due to an intestinal obstruction or unrelieved constipation. There is also diarrhea, which entails an increment in stool and passage of liquid. It is considered a means of getting rid of toxins. It can, however, result in dehydration and electrolyte imbalance (Pellatt, 2013). Incontinence, on the other hand, is the inability to control fecal and gas elimination and is caused by neurological issues or medication. Another concern is flatulence, which is a collection of gas leading to intestinal walls stretching. In such cases, the patient complains of pressure and can be solved through exercise or using an NG tube for decompression. Lastly, some hemorrhoids entail dilated, engorged veins in the rectum lining.

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The Concern for Mrs. Butler

After reading the case study, it evident that Mrs. Butler has constipation. This is a symptom characterized by infrequent stool or by hard, dry, small stools that are problematic to pass. It can be caused by diet, reduced fluids, medication, advanced age, a sedentary lifestyle, or even immobilization due to injury. There is a combination of factors that might have led to the conclusion that Mrs. Butler has constipation, and these include her advanced age the medication. Also, she is not very mobile after she had surgery, which means she has a sedentary lifestyle due to inactivity and no exercise.

Explanation of Answers to Case Study Questions in Sherpath

Question 1

Mrs. Butler's constipation problem is as a result of using opioid medication for pain management. This can be described as opioid-induced constipation resulting from the use of opioids to relieve pain. Mrs. Butler is a surgical patient that led to the application of opioids to manage pain. Opioids are classified as depressants for the central nervous system, which broke pain receptors, thereby reducing pain (Nelson & Camilleri, 2016). Also, they slow down the functioning of the CNS, which has implications on involuntary actions, such as the movement of food in the digestive track, which can lead to constipation. To address the problem of constipation, a stool softener and laxative can be used.

Question 2

The nurse knows that it is essential to begin a bowel medication intervention on the patient to avoid fecal impaction. The unchecked fecal impaction can lead to intestinal obstruction. It is a situation whereby the intestinal content is blocked through bowel (Neri, 2016). Intestinal obstruction can necessitate the need for surgical intervention.

Question 3

All the questions (A, B, C, D) are pertinent assessment questions. Asking the patient these questions concerning their bowel routine, diet, bowel elimination medication, and the iron supplements used at home to provide information essential in determining the best bowel elimination regime for the patient.

Nursing Concerns Relating to Bowel Elimination

Nursing practice is involved in addressing the issue bowel elimination. It is essential to understand that this elimination necessitates a sensitive and emphatic approach coupled with effective communication and skills (Pellatt, 2013). However, there are concerns that nurses face encounter on the management of bowel elimination. One of the concerns is religion and societal considerations since some perceive feces as dirty. Therefore bowel elimination is considered taboo, and patients are embarrassed to disclose any related issue. Another concern is cross-infection in bowel elimination management (Pellatt, 2013). It is, therefore, important for nurses to use prevention measures to ensure the spread of infection is prevented. For instance, it is important to ensure strict handwashing for patients that deal with body waste products. It is also critical that the patient wash their hands after visiting the toilets.

Skills

Skills to Implement in Future Clinical Practice

In bowel elimination management, nurses will encounter various issues. It is, therefore, important that nurses have skills, and these skills are essential in my future clinical practice. First, it is essential that I have knowledge and understanding of how the human body normally functions and possible issues that might occur. It is important to develop effective communication skills since discussion concerning bowel care requires to be performed with sensitivity. The communication questions and methods used by the nurse must be in such a way that they are responsive to the individual patient's needs. It is also important to have an assessment and care planning skills so that they can identify patients with bowel eliminations problems (Thomas, 2017). Additionally, it is essential to have skills on appropriate interventions for patient issues.

Attitude

How to Treat Patients with Dignity and Respect?

Dignity is the maintenance of an individual's self-respect. The provision of care for patients with bowel issues is a sensitive concern, whether in the community or other health care institutions. It is, therefore, important to uphold privacy and dignity in the provision of care. The manner of the provision of care contributes to the patient's sense of dignity. For instance, soft hand care by the nurses was important in showing personal touch and empathy towards the patients. Another way of treating patients with dignity is by ensuring that their views are sought and respected (Billings, 2008). The involvement of patients in the decisions concerning care and making personal decisions is important in dignified care.

What to do in the Nursing Practice to Keep Patient Safe and Free?

It is the responsibility of all stakeholders in healthcare institutions to promote patient safety. The stakeholders include patients, nurses, physicians, legislature, nursing educators, and hospital management, among others (Ballard, 2003). The work environment in which health care is provided underscores the safety of care. In the provision of care, nurses utilize their knowledge, skills, and experience. The quality and safety of patients will be greatly affected by changes in health care work settings. These include the right work setting, patient-centered care, evidence-based practice, team effort and collaboration, and the development of a culture of safety (Hughes, 2008). Nurses can ensure patients are safe and free by ensuring that laws, rules, and standards are followed. Also, nurses can promote the safety of patients by taking the responsibility of appropriate team leaders. The provision of safe care is a collaboration effort of health care workers. It is critical for nurses to understand their competencies, tasks, and legal parameters. They are required to provide necessary direction and supervision in situations where care is provided by others to ensure patients are accorded safe and free care.

References

Ballard, K. A. (2003). Patient Safety: A Shared Responsibility. Online Journal of Issues in Nursing Article, 8(3). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume82003/No3Sept2003/PatientSafety.html

Billings, J. (2008). Privacy and Dignity in Continence Care for Older People. Retrieved February 11, 2020, from https://www.kent.ac.uk/chss/docs/Privacy_and_Dignity_Report_on_Phase_1.pdf

Hughes, R. G. (2008, April). Nurses at the "Sharp End" of Patient Care. Retrieved February 11, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK2672/

Nelson, A. D., & Camilleri, M. (2016). Opioid-induced constipation: advances and clinical guidance. Therapeutic Advances in Chronic Disease, 7(2), 121-134. doi: 10.1177/2040622315627801

Neri, V. (2016). Management of Intestinal Obstruction. Retrieved February 11, 2020, from https://www.researchgate.net/publication/308569802_Management_of_Intestinal_Obstruction

Pellatt, G. C. (2013). Clinical skills: bowel elimination and management of complications. British Journal of Nursing, 16(6), 351-355. doi: 10.12968/bjon.2007.16.6.23008

Thomas, M. (2017). The Royal Children's Hospital Melbourne. Retrieved February 11, 2020, from https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Nursing_assessment/