This document discusses bowel elimination and enemas. It begins by defining defecation and factors that can affect bowel function. It then describes types of altered bowel function and normal patterns. The document focuses on enemas, defining them as the introduction of fluid into the rectum and colon. It describes various types of enemas including cleansing, retention, and rectal washouts. It provides details on administering enemas, including equipment, procedures, solutions used, and contraindications. The overall purpose is to review bowel elimination and the use of enemas to promote or treat bowel function.
This document discusses urinary catheterization and enemas. It defines catheterization as the insertion of a catheter into the urinary bladder and describes the types of catheters including indwelling and intermittent catheters. The document outlines the procedure for catheterization and discusses indications, contraindications and risks. It also defines enemas and describes different types including cleansing, retention and rectal washout enemas. The document provides guidelines for administering enemas and discusses complications.
1. The document describes various methods for terminating a pregnancy in the first and second trimesters, including both medical and surgical options.
2. Common medical first trimester termination methods include mifepristone and misoprostol, methotrexate and misoprostol, while surgical options include menstrual regulation, vacuum aspiration, and dilation and evacuation.
3. Second trimester terminations may involve dilation and evacuation between 13-14 weeks or administration of hypertonic solutions after 14 weeks, along with oxytocin to induce labor. Procedures become more complex in the second trimester.
PHYSIOLOGY AND MANAGEMENT OF THE THIRD AND FOURTH STAGES OF LABOUR.pdfjohnkoffitaylor20
The document describes the physiology and management of the third and fourth stages of labor. It discusses the physiological changes that occur in the third stage, including placental separation, descent and expulsion. It also describes the mechanical and haemostatic factors involved. The document outlines the procedures for both active management of the third stage of labor as well as passive management. It provides details on assessing the mother and newborn during the fourth stage of recovery.
Retained placenta by dr alka mukherjee & dr apurva mukherjeealka mukherjee
Retained placenta after vaginal delivery is diagnosed when a placenta does not spontaneously deliver within a designated amount of time, variably defined as a period of 18–60 mins. It may also be diagnosed if a patient experiences significant hemorrhage prior to delivery of the placenta. Normal placenta delivery requires adequate uterine contractions, with shearing of the placenta and decidua from the uterine wall and expulsion of the tissue. Thus, retained placenta can occur in the setting of significant uterine atony, abnormally adherent placenta, as with placenta accreta spectrum (PAS), or closure of the cervix prior to placental expulsion. Risk factors for retained placenta parallel those for uterine atony and PAS and include prolonged oxytocin use, high parity, preterm delivery, history of uterine surgery, and IVF conceptions. History of a prior retained placenta and congenital uterine anomalies also appear to be risk factors. Management entails manual removal of the placenta with adequate analgesia, as medical intervention alone has not been proven effective. Complications can include major hemorrhage, endometritis, or retained portions of placental tissue, the latter of which can lead to delayed hemorrhage or infection. Prophylactic antibiotics can be considered with manual placenta removal, though evidence regarding effectiveness is inconsistent. If hemorrhage is encountered, deployment of a massive transfusion protocol, uterine evacuation with suction, and use of intrauterine tamponade, as with an intrauterine balloon, should be initiated immediately. When a separation plane between the placenta and uterus is particularly difficult to create, PAS should be considered, and preparations should be made for hemorrhage and hysterectomy. Patients with risk factors for retained placenta should have a laboratory sample sent for blood type and antibody screening on admission to labor and delivery, and plans should be made for appropriate analgesia and preparations for hemorrhage if a retained placenta is encountered.
This document provides an overview of colostomies, including:
- A definition of a colostomy as surgically bringing part of the large intestine through the abdominal wall.
- Classifications of colostomies by purpose (temporary or permanent), function (decompressing or defunctioning), site, and type.
- Indications for colostomies including congenital diseases like Hirschsprung's and acquired diseases like cancer, trauma, or obstruction.
- Details on forming, caring for, and closing a colostomy, as well as potential complications.
- The document is intended as a reference for medical professionals on colostomies.
The document provides instructions for administering an enema and performing colostomy care, outlining the steps to introduce, prepare, and position the patient, insert and administer the enema or change the colostomy pouch, assess the patient's condition, and document the procedure. Key steps include checking the patient's identity, explaining the procedure, ensuring privacy, using proper infection control techniques, assessing the site, and observing the patient after the procedure.
Uterine balloon tamponade in Postpartum Hemorrhage (PPH)Mahantesh Karoshi
This document discusses various techniques for uterine balloon tamponade to control postpartum hemorrhage. It describes the historical use of uterine tamponade, proposed mechanisms of action, and various tools that can be used including the Bakri balloon, condom, Foley catheter, and B-Lynch suture. Commonly used tamponade techniques like the Bakri balloon are prohibitively expensive in many settings. The document then reviews studies on balloon tamponade, noting a 97% success rate in stopping bleeding across 241 cases without randomized controlled trials. It emphasizes the importance of vaginal packing after balloon insertion and provides guidelines for balloon removal.
VARIOUS Temporary CLOSURE TECHNIQUES IN OPEN ABDOMEN.pptxSyedSherazAli10
The document discusses the use of the Bogota bag technique for temporary abdominal closure in patients requiring an open abdomen procedure. Several studies are summarized that examine outcomes in patients managed with the Bogota bag versus other temporary closure methods. The studies found rates of complications like wound infection, intestinal fistula and hernia formation ranging from 5-35% of patients. Mortality rates associated with the underlying conditions rather than the Bogota bag technique ranged from 9-41%. Most studies reported that the Bogota bag achieved the goal of temporary abdominal closure until definitive closure could be performed.
This document discusses urinary catheterization and enemas. It defines catheterization as the insertion of a catheter into the urinary bladder and describes the types of catheters including indwelling and intermittent catheters. The document outlines the procedure for catheterization and discusses indications, contraindications and risks. It also defines enemas and describes different types including cleansing, retention and rectal washout enemas. The document provides guidelines for administering enemas and discusses complications.
1. The document describes various methods for terminating a pregnancy in the first and second trimesters, including both medical and surgical options.
2. Common medical first trimester termination methods include mifepristone and misoprostol, methotrexate and misoprostol, while surgical options include menstrual regulation, vacuum aspiration, and dilation and evacuation.
3. Second trimester terminations may involve dilation and evacuation between 13-14 weeks or administration of hypertonic solutions after 14 weeks, along with oxytocin to induce labor. Procedures become more complex in the second trimester.
PHYSIOLOGY AND MANAGEMENT OF THE THIRD AND FOURTH STAGES OF LABOUR.pdfjohnkoffitaylor20
The document describes the physiology and management of the third and fourth stages of labor. It discusses the physiological changes that occur in the third stage, including placental separation, descent and expulsion. It also describes the mechanical and haemostatic factors involved. The document outlines the procedures for both active management of the third stage of labor as well as passive management. It provides details on assessing the mother and newborn during the fourth stage of recovery.
Retained placenta by dr alka mukherjee & dr apurva mukherjeealka mukherjee
Retained placenta after vaginal delivery is diagnosed when a placenta does not spontaneously deliver within a designated amount of time, variably defined as a period of 18–60 mins. It may also be diagnosed if a patient experiences significant hemorrhage prior to delivery of the placenta. Normal placenta delivery requires adequate uterine contractions, with shearing of the placenta and decidua from the uterine wall and expulsion of the tissue. Thus, retained placenta can occur in the setting of significant uterine atony, abnormally adherent placenta, as with placenta accreta spectrum (PAS), or closure of the cervix prior to placental expulsion. Risk factors for retained placenta parallel those for uterine atony and PAS and include prolonged oxytocin use, high parity, preterm delivery, history of uterine surgery, and IVF conceptions. History of a prior retained placenta and congenital uterine anomalies also appear to be risk factors. Management entails manual removal of the placenta with adequate analgesia, as medical intervention alone has not been proven effective. Complications can include major hemorrhage, endometritis, or retained portions of placental tissue, the latter of which can lead to delayed hemorrhage or infection. Prophylactic antibiotics can be considered with manual placenta removal, though evidence regarding effectiveness is inconsistent. If hemorrhage is encountered, deployment of a massive transfusion protocol, uterine evacuation with suction, and use of intrauterine tamponade, as with an intrauterine balloon, should be initiated immediately. When a separation plane between the placenta and uterus is particularly difficult to create, PAS should be considered, and preparations should be made for hemorrhage and hysterectomy. Patients with risk factors for retained placenta should have a laboratory sample sent for blood type and antibody screening on admission to labor and delivery, and plans should be made for appropriate analgesia and preparations for hemorrhage if a retained placenta is encountered.
This document provides an overview of colostomies, including:
- A definition of a colostomy as surgically bringing part of the large intestine through the abdominal wall.
- Classifications of colostomies by purpose (temporary or permanent), function (decompressing or defunctioning), site, and type.
- Indications for colostomies including congenital diseases like Hirschsprung's and acquired diseases like cancer, trauma, or obstruction.
- Details on forming, caring for, and closing a colostomy, as well as potential complications.
- The document is intended as a reference for medical professionals on colostomies.
The document provides instructions for administering an enema and performing colostomy care, outlining the steps to introduce, prepare, and position the patient, insert and administer the enema or change the colostomy pouch, assess the patient's condition, and document the procedure. Key steps include checking the patient's identity, explaining the procedure, ensuring privacy, using proper infection control techniques, assessing the site, and observing the patient after the procedure.
Uterine balloon tamponade in Postpartum Hemorrhage (PPH)Mahantesh Karoshi
This document discusses various techniques for uterine balloon tamponade to control postpartum hemorrhage. It describes the historical use of uterine tamponade, proposed mechanisms of action, and various tools that can be used including the Bakri balloon, condom, Foley catheter, and B-Lynch suture. Commonly used tamponade techniques like the Bakri balloon are prohibitively expensive in many settings. The document then reviews studies on balloon tamponade, noting a 97% success rate in stopping bleeding across 241 cases without randomized controlled trials. It emphasizes the importance of vaginal packing after balloon insertion and provides guidelines for balloon removal.
VARIOUS Temporary CLOSURE TECHNIQUES IN OPEN ABDOMEN.pptxSyedSherazAli10
The document discusses the use of the Bogota bag technique for temporary abdominal closure in patients requiring an open abdomen procedure. Several studies are summarized that examine outcomes in patients managed with the Bogota bag versus other temporary closure methods. The studies found rates of complications like wound infection, intestinal fistula and hernia formation ranging from 5-35% of patients. Mortality rates associated with the underlying conditions rather than the Bogota bag technique ranged from 9-41%. Most studies reported that the Bogota bag achieved the goal of temporary abdominal closure until definitive closure could be performed.
#www.ABHIJITBHOYAR1@slideshare.in
#Nursing Care.
This topic is Related to the nursing care of colostomy patient. This slide includes the nursing diagnosis also. Share with other nursing students.
This document provides an overview of obstetric fistula, including its causes, management, treatment options, and prevention. It discusses the principles of fistula repair including pre-operative care, surgical techniques, post-operative care, and rehabilitation. Obstetric fistula is a condition that affects many girls and women in resource-poor countries due to complications during childbirth, leaving them isolated and in poverty. The document outlines the medical management and surgical procedures for treating fistula patients to repair damage and restore health. Prevention strategies emphasized include improving access to emergency obstetric care and maternal health services, as well as education programs to help communities understand safe motherhood practices.
Gastric lavage, also known as stomach pumping, is a process used to clean out the contents of the stomach by inserting a tube through the nose or mouth and flushing the stomach with liquid, which is then suctioned out. It is commonly performed when someone has ingested poison, overdosed on drugs, or is bleeding in the upper gastrointestinal tract. The document outlines the goals, objectives, procedure, guidelines, and things to remember when performing gastric lavage to safely and effectively remove harmful substances or excess fluid from the stomach.
Manual vacuum aspiration (MVA) is a surgical method for terminating pregnancies up to 12 weeks gestation. It uses a hand-held syringe with a flexible plastic cannula to apply suction and remove the products of conception from the uterus. MVA has several advantages over other abortion methods as it is simple, safe, can be done on an outpatient basis under local anesthesia, is effective, less traumatic, and quicker. The procedure involves dilating the cervix, inserting the cannula into the uterus, applying suction to evacuate the contents, and inspecting the tissue. Complications can include bleeding, infection, and incomplete evacuation. MVA is an alternative to medical abortion and can also be used diagnost
The document discusses the management of the third stage of labour, which begins with the birth of the baby and ends with delivery of the placenta. It describes the phases of placental separation, descent, and expulsion. It discusses expectant versus active management and the nursing care involved in each approach. The nursing diagnosis identifies risks for fluid deficit, lack of preparation for sensations, and energy expenditure from childbirth efforts. Nursing interventions include monitoring for signs of separation and bleeding, providing education and rest opportunities.
This document provides information on colostomies, including definitions, indications, classifications, formation, care, closure, and complications. A colostomy is a surgical procedure that brings a portion of the large intestine through the abdominal wall. Indications include congenital diseases like Hirschsprung's disease and acquired diseases such as colorectal cancer. Colostomies are classified based on purpose, function, site, type of surgery, and more. Formation involves pre-operative counseling and preparation, careful intra-operative technique, and post-operative care and monitoring. Ongoing colostomy care focuses on mechanical, dietary, skin, and psychological aspects. Complications can arise from formation, closure, or long-
A patient with a history of stroke was brought to the emergency department with abdominal distention. The patient has a urinary catheter that is producing very little urine. On examination, the patient's vital signs were stable but the bladder was distended. The physician is likely to suggest bladder irrigation to relieve the distention and ensure the urinary drainage system remains clear.
PPH, Pressure Balloon Therapy in Uncontrolled Obstetrical Hemorrhagesanjaygole123
PPH, Pressure Balloon Therapy in Uncontrolled Obstetrical Hemorrhage
To know more visit: https://jogi.co.in/articles/articles.php?action=view&row=8283&x=X
The document provides guidelines for urinary catheterization including preparing the patient, performing the procedure aseptically, inserting the catheter into the bladder, securing it, and documenting the process. It describes indications for catheterization as well as contraindications. Potential complications are outlined and care of indwelling catheters is discussed.
Baloon tamponade in management of postpartum haemorrhageAboubakr Elnashar
Uterine balloon tamponade is an effective treatment for postpartum haemorrhage when standard medical treatments have failed. Various balloon devices can be inserted into the uterine cavity and inflated to exert pressure and stop bleeding. Balloons are made of materials like condoms, Foley catheters, or purpose-built devices. When inflated, they work by applying pressure against the uterine walls to compress blood vessels and control bleeding. Balloon tamponade is a minimally invasive option that can prevent the need for hysterectomy in many cases by controlling bleeding without surgery.
Retained placenta is defined as the placenta not being expelled within 30 minutes of birth. There are three causes of retained placenta: interference in the normal separation and descent of the placenta, poor voluntary expulsion, and uterine atonicity from factors like multiparity or prolonged labor. The diagnosis is made based on the time since delivery and assessing signs of separation. Risks of a retained placenta include hemorrhage, shock, and infection. Management depends on whether the placenta is separated or not - separated placentas are expressed by controlled cord traction while unseparated require manual removal under anesthesia.
This document discusses various methods for inducing labor, including natural, mechanical, and pharmacological methods. Natural methods include relaxation techniques, walking, nipple stimulation, and certain foods and herbs. Mechanical methods involve inserting balloon dilators or stripping the membranes to dilate the cervix. Pharmacological induction uses prostaglandins like dinoprostone (PGE2) and misoprostol (Cytotec) administered vaginally or orally, or oxytocin administered via IV infusion. The document outlines the procedures, effects, risks, and evidence for different induction methods to help providers select the most appropriate option for each patient.
A colostomy is a surgical procedure that brings part of the large intestine out through the abdominal wall. It may be temporary to allow an injured or diseased part of the colon to heal, or permanent if the distal colon is removed. There are different types including loop, end, and double barred colostomies. Immediate post-operative care involves monitoring vitals, IV fluids, pain management, and stoma care and education. Long-term care focuses on skin care, odor control, diet, lifestyle modifications, regular pouch changes, social support, and knowing when to consult a doctor. Complications can include gangrene, stenosis, retraction, prolapse, hernias, abscesses, infections,
A colostomy is a surgical procedure that brings part of the large intestine out through the abdominal wall. It may be temporary to allow an injured or diseased part of the colon to heal, or permanent if the distal colon is removed. There are different types including loop, end, and double barred colostomies. Immediate post-operative care involves monitoring vitals, IV fluids, pain management, and stoma care and education. Long-term care focuses on skin care, odor control, diet, lifestyle modifications, regular pouch changes, social support, and knowing when to consult a doctor. Complications can include gangrene, stenosis, retraction, prolapse, hernias, abscesses, infections,
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is commonly performed to treat conditions like cancer, bowel obstructions, or injuries. After surgery, patients require care of the stoma including regularly emptying and changing ostomy pouches. A healthy diet and lifestyle can help manage symptoms and complications after having a colostomy.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is often needed to treat conditions like cancer, bowel obstructions, or injuries. Potential complications include bleeding, infection, or issues with the stoma like necrosis, retraction, or prolapse. Proper care of the stoma and emptying of the colostomy bag is important for recovery. A healthy diet and lifestyle can be maintained after surgery.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is often needed to treat conditions like cancer, bowel obstructions, or injuries. Potential complications include bleeding, infection, or issues with the stoma like necrosis, retraction, or prolapse. Proper care of the stoma and emptying of the colostomy bag is important for recovery. A healthy diet and lifestyle can be maintained after surgery.
1. The document discusses human development from fertilization through birth. It describes the processes of gametogenesis, fertilization, gastrulation, and organogenesis.
2. During gastrulation, the zygote undergoes cell migration and differentiation to form the three germ layers - ectoderm, mesoderm, and endoderm - which go on to generate the major tissues and organ systems.
3. The period from 3-8 weeks is known as the organogenesis stage, where rapid development and differentiation of organs occurs. Exposure to environmental factors during this critical stage can result in birth defects.
The document provides an overview of the digestive system. It discusses that the digestive system breaks down food into smaller particles for absorption by cells in the body. The two main functions are digestion and absorption. The digestive system is divided into the gastrointestinal tract and accessory organs. The gastrointestinal tract extends from the mouth to the anus. Accessory organs include things like the liver and pancreas which release substances into the GI tract.
#www.ABHIJITBHOYAR1@slideshare.in
#Nursing Care.
This topic is Related to the nursing care of colostomy patient. This slide includes the nursing diagnosis also. Share with other nursing students.
This document provides an overview of obstetric fistula, including its causes, management, treatment options, and prevention. It discusses the principles of fistula repair including pre-operative care, surgical techniques, post-operative care, and rehabilitation. Obstetric fistula is a condition that affects many girls and women in resource-poor countries due to complications during childbirth, leaving them isolated and in poverty. The document outlines the medical management and surgical procedures for treating fistula patients to repair damage and restore health. Prevention strategies emphasized include improving access to emergency obstetric care and maternal health services, as well as education programs to help communities understand safe motherhood practices.
Gastric lavage, also known as stomach pumping, is a process used to clean out the contents of the stomach by inserting a tube through the nose or mouth and flushing the stomach with liquid, which is then suctioned out. It is commonly performed when someone has ingested poison, overdosed on drugs, or is bleeding in the upper gastrointestinal tract. The document outlines the goals, objectives, procedure, guidelines, and things to remember when performing gastric lavage to safely and effectively remove harmful substances or excess fluid from the stomach.
Manual vacuum aspiration (MVA) is a surgical method for terminating pregnancies up to 12 weeks gestation. It uses a hand-held syringe with a flexible plastic cannula to apply suction and remove the products of conception from the uterus. MVA has several advantages over other abortion methods as it is simple, safe, can be done on an outpatient basis under local anesthesia, is effective, less traumatic, and quicker. The procedure involves dilating the cervix, inserting the cannula into the uterus, applying suction to evacuate the contents, and inspecting the tissue. Complications can include bleeding, infection, and incomplete evacuation. MVA is an alternative to medical abortion and can also be used diagnost
The document discusses the management of the third stage of labour, which begins with the birth of the baby and ends with delivery of the placenta. It describes the phases of placental separation, descent, and expulsion. It discusses expectant versus active management and the nursing care involved in each approach. The nursing diagnosis identifies risks for fluid deficit, lack of preparation for sensations, and energy expenditure from childbirth efforts. Nursing interventions include monitoring for signs of separation and bleeding, providing education and rest opportunities.
This document provides information on colostomies, including definitions, indications, classifications, formation, care, closure, and complications. A colostomy is a surgical procedure that brings a portion of the large intestine through the abdominal wall. Indications include congenital diseases like Hirschsprung's disease and acquired diseases such as colorectal cancer. Colostomies are classified based on purpose, function, site, type of surgery, and more. Formation involves pre-operative counseling and preparation, careful intra-operative technique, and post-operative care and monitoring. Ongoing colostomy care focuses on mechanical, dietary, skin, and psychological aspects. Complications can arise from formation, closure, or long-
A patient with a history of stroke was brought to the emergency department with abdominal distention. The patient has a urinary catheter that is producing very little urine. On examination, the patient's vital signs were stable but the bladder was distended. The physician is likely to suggest bladder irrigation to relieve the distention and ensure the urinary drainage system remains clear.
PPH, Pressure Balloon Therapy in Uncontrolled Obstetrical Hemorrhagesanjaygole123
PPH, Pressure Balloon Therapy in Uncontrolled Obstetrical Hemorrhage
To know more visit: https://jogi.co.in/articles/articles.php?action=view&row=8283&x=X
The document provides guidelines for urinary catheterization including preparing the patient, performing the procedure aseptically, inserting the catheter into the bladder, securing it, and documenting the process. It describes indications for catheterization as well as contraindications. Potential complications are outlined and care of indwelling catheters is discussed.
Baloon tamponade in management of postpartum haemorrhageAboubakr Elnashar
Uterine balloon tamponade is an effective treatment for postpartum haemorrhage when standard medical treatments have failed. Various balloon devices can be inserted into the uterine cavity and inflated to exert pressure and stop bleeding. Balloons are made of materials like condoms, Foley catheters, or purpose-built devices. When inflated, they work by applying pressure against the uterine walls to compress blood vessels and control bleeding. Balloon tamponade is a minimally invasive option that can prevent the need for hysterectomy in many cases by controlling bleeding without surgery.
Retained placenta is defined as the placenta not being expelled within 30 minutes of birth. There are three causes of retained placenta: interference in the normal separation and descent of the placenta, poor voluntary expulsion, and uterine atonicity from factors like multiparity or prolonged labor. The diagnosis is made based on the time since delivery and assessing signs of separation. Risks of a retained placenta include hemorrhage, shock, and infection. Management depends on whether the placenta is separated or not - separated placentas are expressed by controlled cord traction while unseparated require manual removal under anesthesia.
This document discusses various methods for inducing labor, including natural, mechanical, and pharmacological methods. Natural methods include relaxation techniques, walking, nipple stimulation, and certain foods and herbs. Mechanical methods involve inserting balloon dilators or stripping the membranes to dilate the cervix. Pharmacological induction uses prostaglandins like dinoprostone (PGE2) and misoprostol (Cytotec) administered vaginally or orally, or oxytocin administered via IV infusion. The document outlines the procedures, effects, risks, and evidence for different induction methods to help providers select the most appropriate option for each patient.
A colostomy is a surgical procedure that brings part of the large intestine out through the abdominal wall. It may be temporary to allow an injured or diseased part of the colon to heal, or permanent if the distal colon is removed. There are different types including loop, end, and double barred colostomies. Immediate post-operative care involves monitoring vitals, IV fluids, pain management, and stoma care and education. Long-term care focuses on skin care, odor control, diet, lifestyle modifications, regular pouch changes, social support, and knowing when to consult a doctor. Complications can include gangrene, stenosis, retraction, prolapse, hernias, abscesses, infections,
A colostomy is a surgical procedure that brings part of the large intestine out through the abdominal wall. It may be temporary to allow an injured or diseased part of the colon to heal, or permanent if the distal colon is removed. There are different types including loop, end, and double barred colostomies. Immediate post-operative care involves monitoring vitals, IV fluids, pain management, and stoma care and education. Long-term care focuses on skin care, odor control, diet, lifestyle modifications, regular pouch changes, social support, and knowing when to consult a doctor. Complications can include gangrene, stenosis, retraction, prolapse, hernias, abscesses, infections,
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is commonly performed to treat conditions like cancer, bowel obstructions, or injuries. After surgery, patients require care of the stoma including regularly emptying and changing ostomy pouches. A healthy diet and lifestyle can help manage symptoms and complications after having a colostomy.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is often needed to treat conditions like cancer, bowel obstructions, or injuries. Potential complications include bleeding, infection, or issues with the stoma like necrosis, retraction, or prolapse. Proper care of the stoma and emptying of the colostomy bag is important for recovery. A healthy diet and lifestyle can be maintained after surgery.
A colostomy is a surgical procedure where a portion of the large intestine is brought through the abdominal wall to carry stool out of the body. It may be temporary or permanent and is often needed to treat conditions like cancer, bowel obstructions, or injuries. Potential complications include bleeding, infection, or issues with the stoma like necrosis, retraction, or prolapse. Proper care of the stoma and emptying of the colostomy bag is important for recovery. A healthy diet and lifestyle can be maintained after surgery.
1. The document discusses human development from fertilization through birth. It describes the processes of gametogenesis, fertilization, gastrulation, and organogenesis.
2. During gastrulation, the zygote undergoes cell migration and differentiation to form the three germ layers - ectoderm, mesoderm, and endoderm - which go on to generate the major tissues and organ systems.
3. The period from 3-8 weeks is known as the organogenesis stage, where rapid development and differentiation of organs occurs. Exposure to environmental factors during this critical stage can result in birth defects.
The document provides an overview of the digestive system. It discusses that the digestive system breaks down food into smaller particles for absorption by cells in the body. The two main functions are digestion and absorption. The digestive system is divided into the gastrointestinal tract and accessory organs. The gastrointestinal tract extends from the mouth to the anus. Accessory organs include things like the liver and pancreas which release substances into the GI tract.
Bacteria are classified based on taxonomy, nomenclature, and observational techniques. Morphology, staining properties, motility, growth characteristics, biochemical activities, and genetics are used to classify and identify bacteria. Bacterial cells have a cell envelope consisting of a capsule, cell wall, and cell membrane. The cell envelope encloses cellular elements like ribosomes, nucleoid, and mesosomes. Some bacteria also have extracellular appendages like flagella and pili.
The document discusses casts, including their definition, types, application process, and removal process. It defines a cast as a rigid external device used to immobilize and support fractures, deformities, and injuries. It describes various types of casts such as short arm, long arm, short leg, and shoulder spica casts. It provides a 12 step process for applying a plaster cast including prepping the patient and area, applying stockinette, cotton, and plaster, and molding and drying the cast. It also outlines the equipment and steps for cast removal using a saw and spreaders.
This document outlines different classes of adrenergic drugs including agonists and antagonists. Adrenergic agonists can be direct-acting, mimicking norepinephrine, or indirect-acting, promoting norepinephrine release. Examples include epinephrine, norepinephrine, dopamine, and isoproterenol. Adrenergic antagonists block receptors and include alpha blockers like prazosin and beta blockers like propranolol. Indirect antiadrenergic agents decrease norepinephrine release through mechanisms like depletion from neurons (reserpine) or inhibition of release (guanadrel).
Pain serves as a protective mechanism and is part of the normal healing process. Analgesics are drugs that selectively relieve pain by acting in the central nervous system or peripheral mechanisms without significantly altering consciousness. They are largely classified as opioids like morphine and codeine or NSAIDs like aspirin and ibuprofen. Opioids act by binding to opioid receptors in the CNS to produce analgesic effects, while NSAIDs block prostaglandin production by inhibiting the cyclooxygenase pathway to reduce inflammation and pain. Both drug classes can cause adverse effects like gastrointestinal issues, bleeding risks, and dependence/withdrawal symptoms that require careful consideration of risks and benefits when used clinically.
The document discusses surgical conscience and ethics. It defines surgical conscience as doing unto patients as you would want done to yourself. This involves respecting patients, their privacy, beliefs and needs. Reporting incidents and being honest are also important ethical responsibilities. Situations like peer apathy, stress or personal problems can undermine surgical conscience. The document also outlines legal aspects of surgery, criminal responsibilities, areas of negligence and hazards in the operating room environment.
This document provides an overview of different types of anesthesia including local, regional, and general anesthesia. It discusses key terms, types of local anesthesia including infiltration and nerve blocks, common local anesthetic agents and their uses. Regional anesthesia techniques like epidural and spinal anesthesia are also covered. The stages of general anesthesia induction, excitement, relaxation, and danger are defined. Methods of administering general anesthesia via inhalation are described.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Histololgy of Female Reproductive System.pptxAyeshaZaid1
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2. Objectives
• Upon completion of this chapter, you will be able to do the
following:
Identify factors that affect bowel elimination.
Define what enema is.
List the indications and purposes of enema.
Identify and discuss the types of enema.
Demonstrate administration of enema
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BY:mulualem(BSC,msc adult health nursing)
4. Bowel Elimination
The elimination of waste from the bowel is an essential body
function.
Defecation is the process by which the solid waste products
of digestion, known as feces or stool, are eliminated from the
bowel.
The major nursing responsibilities associated with bowel
elimination include assessing bowel function, promoting
normal bowel health, and intervening to manage alterations
in bowel function
8/20/2023 BY:mulualem(BSC,msc adult health nursing) 4
9. Normal Pattern Identification
• To determine the patient’s current bowel elimination
pattern, obtain the following information from current
medical records, the patient, or the caregiver:
What is the patient’s usual pattern of bowel elimination?
What are the usual characteristics of the patient’s stool?
Which aids, if any, does the patient routinely use for
defecation?
When was the patient’s last bowel movement?
Are there any recent changes in the patient’s normal bowel
pattern?
8/20/2023 BY:mulualem(BSC,msc adult health nursing) 9
10. Physical Assessment
Visual inspection of the feces and physical assessment
of the abdomen and perirectal area provide objective
data on the patient’s bowel elimination status.
Inspection, auscultation, percussion, palpation, and
measurement of abdominal girth are used
8/20/2023 BY:mulualem(BSC,msc adult health nursing) 10
13. Measures to Promote Bowel Elimination
Nurses commonly use two interventions:
inserting suppositories and administering enemas:
to promote elimination when it does not occur naturally
or when the bowel must be cleansed for other purposes,
such as preparation for surgery and endoscopic or x-ray
examinations
8/20/2023 BY:mulualem(BSC,msc adult health nursing) 13
14. Inserting a Rectal Suppository
Medications released from the suppository can have
local or systemic effects.
Depending on the drug, local effects may include
softening and lubricating dry stool, irritating the wall of
the rectum and anal canal to stimulate smooth muscle
contraction, and liberating carbon dioxide, thus
increasing rectal distention and the urge to defecate.
BY:mulualem(BSC,msc adult health nursing)
14 8/20/2023
15. Enema Administration
Enema:
Is the introduction of fluid into rectum and sigmoid colon for
cleansing, therapeutic or diagnostic purposes.
the procedure of introducing liquids into the rectum and colon via the anus.
Indication
To evacuate the bowel prior to surgery or investigation
To administer medication
For the treatment of sever constipation
treatment for encopresis/ impacted stool in the colon and
rectum
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BY:mulualem(BSC,msc adult health nursing)
18. …..Enema
• Mechanisms of some solutions used in enema
Tap water: increase peristalsis by causing mechanical
distension of the colon.
Soap solution: increases peristalsis due to irritating effect of
soap to the luminal mucosa of the colon.
Epsum salt: The concentrated solution causes flow of ECF
(extra cellular fluid) to the lumen causing mechanical
distension resulting in increased peristalsis.
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20. ….Types of enema
BY:mulualem(BSC,msc adult health nursing)
20
1. Cleansing enema
administered to remove feces from the colon.
Hot – cause injury to the bowel mucous
Cold – uncomfortable and may trigger a spasm of the
sphincter muscles
High enema is given to clean as much of the colon as
possible. up to 1000 ml of fluid for adult
Low enema is administered to clean the rectum and
sigmoid colon only. Approximately 150ml of fluid is used.
8/20/2023
21. Purpose
BY:mulualem(BSC,msc adult health nursing)
21
To stimulate peristalsis and remove feces or flatus.
To relieve constipation or fecal impaction
To prevent involuntary escape of fecal matter during surgical
procedure or a delivery.
For incontinent patients to keep the colon empty
To help establish regular bowel function.
For diagnostic test
Before certain x-ray exam – barium enema
To promote visualization of intestinal tract by x-ray Colonoscopy
8/20/2023
22. Cont..
BY:mulualem(BSC,msc adult health nursing)
22
types of solutions used for cleansing enema are
Tap water( most time)
Normal saline solution,
Soap solution, and
Hypertonic solutions.
8/20/2023
23. Cont..
BY:mulualem(BSC,msc adult health nursing)
23
The amount of solution to be administered depends
on:
The Kind of enema
The age of the person and
The person’s ability to retain the solution
8/20/2023
24. Cont..
BY:mulualem(BSC,msc adult health nursing)
24
The large volume of solution for adult is 500-1000ml and
for infant is 150-250ml.
The rectal tube is measured in French scale
Age Size
Infants 10-12 fr
School age child 16-18 fr
Adults 22-30 fr
8/20/2023
27. Procedure
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1. Assemble the needed equipment in one place.
Rationale: It is more efficient to assemble equipment in one
place.
2. Prepare solution. Check temperature of solution
by pouring some over your inner wrist
2. Fill enema bag with 750 to 1,000 mL lukewarm
solution (105 to 110F; for child, 500 mL or less,
100F
Rationale: Intestinal mucosa can be damaged if the solution is too warm. Cold solutions are
difficult to retain and can
cause abdominal cramping.
3. Open clamp on tubing and allow solution to flow
through tubing to remove the air (Fig. 3 ). Reclamp
tubing. Rationale: Air in the rectum causes discomfort
28. …..procedure
4. Provide privacy by closing curtains or room door
5. Identify patient .Position patient on left side
(Sims’ position) with right knee flexed.
6. Cover patient with bath blanket, exposing only the
buttock
7. Put on disposable gloves. Place waterproof pad under patient’s buttocks
8. Lubricate 2 to 3 inches of the tip of the rectal tube
with water-soluble lubricant
9. Separate the buttocks to visualize the anus. Observe
for external hemorrhoids. Ask patient to take a slow,
deep breath. Gently insert the tube, directing the tip
toward the umbilicus (7-10 cm in an adult smoothly and slowly, 5-7.5 cm in the child, and 2.5-3.75 cm in an
infant
8/20/2023
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29. …..procedure
10.Continue holding the tube in the rectum With other hand, open the clamp and allow
solution to slowly enter the patient. Raise container 18 inches above the anus, allowing
solution to flow slowly over 5 to 10 minutes; if patient complains of cramping or pain, have
patient breathe deeply and lower bag until the sensation stops
11. Reclamp tubing when desired amount of solution
has infused.
12.Remove tube gently and have patient squeeze buttocks together firmly for several
minutes.
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30. …..procedure
13. Have patient retain solution as long as possible.
14. Assist patient to bathroom, commode, or bedpan
15. Visually inspect character of the feces and solution
16. Assist patient into comfortable position. Assist with cleansing as needed. Provide
materials for patient to wash hands. Open windows or provide air freshener if needed.
Clean and dispose of equipment as necessary. Remove gloves and wash hands
8/20/2023
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31. 2. Retention Enema
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Administration of solution to be retained in rectum for
short or long period
for local or general effects
E.g. oil retention enema
32. Cont…
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Is given slowly by means of a rectal tube
The amount of fluid is usually 150-200 cc
Cleansing enema is given after the retention time is
over
Temperature of enema fluid is 37.4 c or body
35. Cont.…
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Most medicated retention enema must be preceded by a
cleansing enema. ( ½ hrs before giving retention enema
Elevate foot of bed to help patient retain enema
Kinds of solution used to supply body with fluid are
plain H2O,
normal saline,
glucose 5%
Olive oil 100-200 cc to be retained for 6-8 hrs is given
for sever constipation
36. 3.PASSING A FLATUS TUBE
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36
It is a process of introducing a tube rectally to relieve
abdominal distention caused by accumulation of gas
(flatulence).
The tube stimulates peristalsis and provide
passageway for gases to escape from the intestine.
Purpose
To decrease flatulence (severe abdominal distention)
Before giving the retention enema
37. Procedure
8/20/2023
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37
Place the patient in a left lateral position
Lubricate the tube about 15cm
Separate the buttock & insert 12-15cm
The end of the tube should reach the tap water solution in the
bowl.
The amount of air passed can be seen bubbling through the
solution.
Leave the tube in place for a period of time, no longer than 20min.
Reinsert the tube every 2-3 hrs if the distention has been
unrelieved or reaccumulates.
38. 4. Rectal Washout (Siphoning Enema) (Colon
irrigation or colonic flush)
8/20/2023
BY:mulualem(BSC,msc adult health nursing)
38
Is the process of introducing large amount of fluid into
large bowel for flushing purpose and allow return or
wash out fluid
Purpose
To prepare the patient for x-ray exam and
sigmoidoscopy
To prepare the patient for rectum and colon operation
40. Procedure
8/20/2023
BY:mulualem(BSC,msc adult health nursing)
40
Insert the tube like the cleansing enema
Open the clamp and allow to run about 1,000 cc of fluid in
the bowel, then drain off back into the bucket
Carry on the procedure until the fluid return is clear
41. Note:
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41
The procedure should not take > 2 hrs
Should be finished 1 hr before exam or x-ray – to give
time for the large intestine to absorb the rest of the
fluid
Allow the fluid to pass slowly
Amount of solution
5-6 liters or until the wash out rectum fluid becomes clear
42. Contraindications of enema
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42
Acute abdominal pain
some abdominal surgery
CHF
Intestinal intussusceptions
uncontrolled hypertension
Rectal or abdominal tumors
Intestinal perforation
Pregnancy
44. …Types of enema
• Similar with cleansing enema but the enema should be
administered very slowly.
• Is given slowly by means of rectal tube and the should be
lower than leg
• The tube for retention enema is smaller
• Indicated to relieve constipation by softening fecal
impact.
• Solution is usually oil, retained for up to 3hrs and
followed by cleansing enema
8/20/2023 44
BY:mulualem(BSC,msc adult health nursing)
45. • Carminative Enema
• A small volume enema given to release flatus. Traditionally the
enema consisted of two ounces of glycerin, one ounce of
magnesium sulfate (Epsom salts) and three ounces of water.
• The combination of ingredients stimulated peristalsis resulting
in a bowel movement in which feces and flatus are expelled.
• The advantage in times past of using the carminative enema
was that the low volume made it comfortable for the patient to
retain, and it took little time to administer.
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46. • When using the traditional carminative enema,
instruct the patient to try to retain the enema for five
to ten minutes before expelling.
• For adult, 60-180ml of fluid is installed.
8/20/2023 46
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47. Enema…Types of enema
• Return flow
– Also called rectal washout or colonic irrigation
– Alternating flow of 100 to 200ml of fluid into and out
of the large intestine stimulates peristalsis and the
expulsion of feces.
– The container is then lowered and the solution flow
back through the enema tubing to the container.
– Flatus also return.
8/20/2023 47
BY:mulualem(BSC,msc adult health nursing)
48. procedure
• Enema for adults are usually given at 40-430c and for
children at 37.70c
• Hot – cause injury to the bowel mucous
• Cold – uncomfortable and may trigger a spasm of
the sphincter muscles
• The amount of solution given depends on:
– Kind of enema
– The age of the person
– The person ability to retain the solution
8/20/2023 48
BY:mulualem(BSC,msc adult health nursing)
49. Enema
• Amount of solution and size of the tube
inserted should be age appropriate
Age Amount of fluid
–18month 50-200ml
–18monz-5 yrs 200-300ml
–5-12 yrs 300-500ml
–> 12 yrs 500-1000ml
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50. Enema
• Amount of solution and size of the tube
inserted should be appropriate…
• Age Size of the tube
–Infant/small child 10-12fr
–Toddler 14-16fr
–School age child 16-18fr
–Adult 22-30fr
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51. Enema: Administering a Large Enema
• Equipment
– Enema bag
– Enema tube
– Water-soluble lubricant
– Glove
– Soap solution(1000ml)
– Rubber sheet
– Gauze or soft paper(for perineal care)
– Bed pan
– Forceps(to clamp) and Thermometer
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52. Enema: Administering a Large Enema
• Assemble equipment, explain the procedure to the
patient, screen , hand wash and position(left or sim’s
with right leg flexed) the patient including drape.
• Prepare the solution, assure temperature within
range of 99° to 102°F(40-43oc) by using a
thermometer or placing a few drops on your wrist.
• Wash hands and don gloves
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BY:mulualem(BSC,msc adult health nursing)
53. Enema: Administering a Large Enema
• Assist patient to left side-lying position, with right knee bent.
• In high cleansing enema the client changes from the left lateral to
the dorsal recumbent position and then to the right lateral position
during the administration so that the fluid can follow the large
intestine
• Hang bag of enema solution 12 to 18 inches above anus.
• Lubricate 4 to 5 inches of catheter tip.
• Place bedpan, commode, robe and slippers within easy reach.
• Separate buttocks, insert catheter tip into anal opening, slowly
advance catheter approximately 4 inches(7-10cm).
8/20/2023 53
BY:mulualem(BSC,msc adult health nursing)
54. Enema: Administering a Large Enema
• Slowly infuse solution via gravity flow; bag
height may be increased but not to exceed 18
inches above anal opening.
8/20/2023 54
BY:mulualem(BSC,msc adult health nursing)
55. Enema: Administering a Large Enema
• If client complains of increased pain or
cramping, or if fluid is not being retained, stop
procedure, wait a few minutes, then restart.
• Clamp tubing when fluid finishes infusing;
remove catheter tip.
• Assist client to bedpan, commode, or toilet
• Discard equipment in proper place.
• If equipment is reusable, properly clean and
store it.
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BY:mulualem(BSC,msc adult health nursing)
56. Enema: Administering a Large Enema
• Remove gloves and wash hands.
• Instruct client to call for assistance when finished
eliminating, or if untoward feeling occurs, such
as lightheadedness or dizziness.
• Assist client with washing if needed
• Documentation
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57. Contraindications / Precautions / Warnings
• Never use an enema if rectal bleeding is present.
• Never give children under ten more than one enema daily, as
this may cause hyponatremia, where blood sodium levels drop
to dangerously low due to increased water intake.
• Patients who are bleeding or experiencing a prolapse from the
rectum should also not be given enemas of any kind.
Likewise, people with unresolved abdominal pain can be at
risk because distension of the colon could be dangerous.
• Enema is also contra indicated in acute gastro intestinal
gastric obstruction
8/20/2023 BY:mulualem(BSC,msc adult health nursing) 57
58. retention enema is contraindicated.
• For severe kidney problem patients
• For cardiac patients
If you use tape water for enema it should not
greater than 500 ml.
More than 3 tap water enemas is not given
consecutively.
8/20/2023 BY:mulualem(BSC,msc adult health nursing) 58
59. Complications / Risks of Enema
• Main dangers are:
• Irritation of the rectal mucosa by too much soap or
an irritating soap.
• Osmosis (fluid drawn into colon from surrounding
tissues) if hypertonic solution is used.
• Water intoxication if hypotonic solution is used.
• Electrolyte imbalances.
8/20/2023 BY:mulualem(BSC,msc adult health nursing) 59
Editor's Notes
Two types of movements—segmentation and peristalsis—occur
within the intestine and are responsible for assisting with absorption and transportation of waste products over the full length
of the intestines. During segmentation, alternating contraction
and relaxation of the intestinal smooth muscle occur. This type
of movement slows the passage of intestinal contents to permit
more complete digestion and absorption of nutrients.
The second type of movement, peristalsis, propels the intestinal contents along the entire length of the small and large intestines. The walls of the intestine refl exively induce peristalsis, but
peristalsis is particularly stimulated when partially digested food
enters the duodenum from the stomach. This duodenocolic
reflex is especially strong when food or fl uids enter the duodenum after several hours of not eating