Today I will be discussing bowel elimination. I know, to some, this may seem like quite a gruesome subject but i actually love talking about it! It's so facinating! My mum and dad, before i started nursing, were concerned that I wouldn't get used to the 'bad sights' i.e. blood, poo, wee and many more. But actually i don't find it too bad. Anyway, the point i'm trying to make is that it's just a fact of life and it's just part of human anatomy. So, here we go...
GI tract
*Is a tube from the mouth to the anus
*Consists of smooth muscle
*7.5m long
*Includes pharnyx, oesophagus, stomach, small and large intestine
Important organs of the GI tract
Mouth
*Tongue provides taste
*3 gland produce saliva...
1.parotid
2.sub-mandibular
3.sublingual
Pharnyx
*Allows passage of food from mouth to oesophagus
*Epiglottis closes over larnyx to prevent aspiration
Oesophagus
*Muscular tube
*25.5cm long
*moves food from pharnyx to stomach
*Fibres contract, propelling food into the stomach
*Lower end remains closed to prevent reflux of gastric contents
Stomach
*contains two sphincters (muscles)...
1. Cardiac (Protects the entrance to the stomach)
2. Pyloric (Guards exit)
*Stores food
*Mixes food wih gastric juices
Small intestine
*End products of digestion are absorbed through membrane lining of small intestine and into the blood stream
*Nearly ALL digestion and reabsorption takes place in the small intestine
Large intestine
*Absorbs excess water
*Stores food residue
*Eliminates waste
Liver
*Metabolises proteins, fast and carbohydrates
*Detoxifies the blood
*Converts ammonia to urea
*Synthesises proteins, amino acids, vitamin A, D, K and B
*Creates bile to help digest fats and absorb cholesterol
Gallbladder
*Found under the right side of the liver
*Stores bile
Pancreas
*Releases insulin and glycogen into the blood
Key Terms
Mastication - Chewing
Deglutition - Swallowing
Polyuria - increase in volume of urine
Nocturia - getting up frequently in the night to urinate
Anuria - nonpassage of urine
Oliguris - production of abnormally small amounts of urine
Dysuria - Painful urination
Characteristics of normal stool 
25% solids
75% water
*Consists of bacteria, undigested fibre, fat, inorganic matter and protein
*Bilirubin produces brown colour of stool
*Bacterial decomposition of proteins creates unpleasant odour of stools
*The 'Bristol Stool Chart' is a chart that is widely used in healthcare settings to determine the type of consistancy of stools
Charateristics of abnormal stool
*White stools indicate malabsoption disorder or blockage in the liver
*Thin stools may indicate haemorrhoids or colorectal cancer
Factors affecting elimination
*Body position - Sitting aids bowel movement. Can be difficult for patients to go when on a bed pan because squatting aids bowel movement.
*Exercise - good muscle tone aids elimination. Reduced physical activity can increase chance of constipation.
*Faecal diversion - alternate route for bowel elimination is called a 'stoma'. This is sometimes performed in patients with bowel cancer, bowel obstruction or in crohn's disease.
Two types of stoma
1. Ileostomy - Part of small intestine redirected through abdominal wall
2. Colostomy - Part of large intestine or colon is redirected through the abdominal wall.
*Fluid intake - Decreased fluid intake means the stools become hard and difficult to pass. The longer the stool remains in the colon, the more dry is becomes. Stool that doesn't remain long in the colon will be watery, resulting in fluid loss.
*Ignoring the urge to defecate - for patients with chronic conditions (or haemorrhoids) it may be painful to go to the toilet or due to lack of privacy they may not be able to go. Both can lead to constipation.
*Lifestyle - Bowel movement is convenient for their lifestyle. Stress, fear, anxiety, anger or depression, including the stress of hospitalisation can alter ones bowel elimination.
*Medication - Opioids and iron tablets can cause constipation. Antibiotics can cause diahorrea. Antacids can cause either.
*Nutrition - increased fibre in diet assists in bowel function (i.e. fruits, veg, cereals.)
Urinalysis 
*Urine dip tests - Dip the test stick in the urine specimen for 30 seconds and observe the change in colour against the corresponding chart on the bottle.
*The urine specimen bottles are usually red and have boric acid inside in order to preserve the specimen
*24 hours urine collection bottles (More like 'tubs' i guess...) comes in large white bottles. Make sure these are labelled correctly with the time and date on.
Understanding Urinalysis Results
*Glucose - Excess sugar in the urine usually indicates diabetes mellitus
*Ketones - Indicates diabetic ketosis or calorie deprivation
*Blood - Indicates infection
*Proteins - A small amount of filtered plasma proteins can be found in normal urine but total protein excretion does not normally exceed
150mg/24 hour. If a ppositive reaction is seen this usually indicates infection or poor kidney function
*Bilirubin - Indicates poor liver function, serosis or anaemia
*pH - Normal range approx. 7.4 to 6 in the final urine
*Specific gravity - measures urine density, or the ability of the kidney to concentrate or dilute the urine over that of plasma. A score of 1.002 and 1.035 is considered normal.
Okay, so that's it for today I'm afraid! But i really hope you enjoyed reading this post! To those who aren't nurses, this might sound overbearing but, as a nurse, you just deal with this sorta thing and you realise that it's just human nature and it's nothing to be embarassed about. I also want to say, thank you very much to all my wonderful readers out there - even if you total just one or two, you still mean a lot to me! Thank you for continually reading what I post! See you again soon!
Emily
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