Pathophysiology: Inflammation of the veins in anus and rectum caused by straining or pressure, which allows for the veins to swell and be inflamed.
Overview
<ol>
<li style="font-weight: 400;">Swollen and inflamed veins of the anus and lower rectum</li>
</ol>
<h3>Nursing Points</h3>
<h4 style="padding-left: 30px;">General</h4>
<ol style="padding-left: 60px;">
<li style="font-weight: 400;">Causes
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Portal hypertension</li>
<li style="font-weight: 400;">Straining</li>
<li style="font-weight: 400;">Irritation</li>
<li style="font-weight: 400;">Pregnancy / Postpartum</li>
</ol>
</li>
<li style="font-weight: 400;">Types
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Internal</li>
<li style="font-weight: 400;">External</li>
<li style="font-weight: 400;">Prolapsed</li>
</ol>
</li>
</ol>
<h4 style="padding-left: 30px;">Assessment</h4>
<ol style="padding-left: 60px;">
<li style="font-weight: 400;">Rectal pain</li>
<li style="font-weight: 400;">Bright red bleeding with defecation</li>
<li style="font-weight: 400;">Bulging skin/veins around anus</li>
</ol>
<h4 style="padding-left: 30px;">Therapeutic Management</h4>
<ol style="padding-left: 60px;">
<li style="font-weight: 400;">Sitz-bath
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Soak perineum in warm water for 15-20 minutes</li>
<li style="font-weight: 400;">Can add baking soda or epsom salts</li>
</ol>
</li>
<li style="font-weight: 400;">Increase flow of stool to prevent constipation and straining
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">High fiber diet</li>
<li style="font-weight: 400;">↑ Fluid intake</li>
<li style="font-weight: 400;">Stool softeners</li>
</ol>
</li>
<li style="font-weight: 400;">Cold packs and analgesics</li>
<li style="font-weight: 400;">Surgical Removal &#8211; Hemorrhoidectomy</li>
</ol>
<h4 style="padding-left: 30px;">Nursing Concepts</h4>
<ol style="padding-left: 60px;">
<li style="font-weight: 400;">Comfort</li>
<li style="font-weight: 400;">Nutrition</li>
<li style="font-weight: 400;">Elimination</li>
</ol>
<h4>Patient Education</h4>
<ol>
<li style="font-weight: 400;">Do not strain during bowel movement</li>
<li style="font-weight: 400;">Take stool softeners as needed (not daily/regularly)</li>
</ol>

Med-Surg | Gastrointestinal

02-04-nursing-care-and-pathophysiology-for-hemorrhoids

02.04 Nursing Care and Pathophysiology for Hemorrhoids

<h3>Overview</h3>
<ol>
<li style="font-weight: 400;">Constipation
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Infrequent and hard to pass stools</li>
<li style="font-weight: 400;">&gt;2 weeks </li>
</ol>
</li>
<li style="font-weight: 400;">Encopresis
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Voluntary or involuntary fecal incontinence in children who were previously toilet trained (&gt;4 yrs) </li>
<li style="font-weight: 400;">Usually caused by chronic constipation
<ol style="list-style-type: lower-roman;">
<li style="font-weight: 400;">“Leakage” around fecal impaction </li>
</ol>
</li>
<li style="font-weight: 400;">Sometimes caused by emotional problems</li>
</ol>
</li>
</ol>
<h4>Nursing Points</h4>
<h4>General</h4>
<ol>
<li style="font-weight: 400;">Possible causes
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Structural
<ol style="list-style-type: lower-roman;">
<li style="font-weight: 400;">Hirschsprung disease
<ol>
<li style="font-weight: 400;">Missing nerve cells in the colon</li>
</ol>
</li>
</ol>
</li>
<li style="font-weight: 400;">Spinal cord lesions (Spina bifida) 
<ol style="list-style-type: lower-roman;">
<li style="font-weight: 400;">Loss of tone &amp; sensation in the bowel</li>
</ol>
</li>
<li style="font-weight: 400;">Medications
<ol style="list-style-type: lower-roman;">
<li style="font-weight: 400;">Antiepileptics</li>
<li style="font-weight: 400;">Antacids</li>
<li style="font-weight: 400;">Opioids</li>
<li style="font-weight: 400;">Iron supplements</li>
</ol>
</li>
<li style="font-weight: 400;">Idiopathic (Functional)
<ol>
<li style="font-weight: 400;">Most common</li>
<li style="font-weight: 400;">No (disorder)  cause found</li>
<li style="font-weight: 400;">Dietary 
<ol>
<li style="font-weight: 400;">Lack of fiber</li>
<li style="font-weight: 400;">Decreased fluid intake </li>
<li style="font-weight: 400;">Excess cow’s milk </li>
</ol>
</li>
<li style="font-weight: 400;">Environmental/Psychosocial 
<ol>
<li style="font-weight: 400;">Fear of using public toilet </li>
<li style="font-weight: 400;">Change in routine</li>
<li style="font-weight: 400;">Previous experiences with painful stooling</li>
</ol>
</li>
</ol>
</li>
</ol>
</li>
</ol>
<h4>Assessment</h4>
<ol>
<li style="font-weight: 400;">Constipation
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Bristol Stool Chart</li>
<li style="font-weight: 400;">Abdominal pain</li>
<li style="font-weight: 400;">Painful bowel movements</li>
<li style="font-weight: 400;">Blood-streaked stool </li>
<li style="font-weight: 400;">Encopresis </li>
<li style="font-weight: 400;">Decreased appetite</li>
<li style="font-weight: 400;">Decreased bowel sounds</li>
</ol>
</li>
<li style="font-weight: 400;">Newborn constipation
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Meconium ileus 
<ol style="list-style-type: lower-roman;">
<li style="font-weight: 400;">First stool delayed over 24 hours </li>
<li style="font-weight: 400;">Usually indicates-
<ol>
<li style="font-weight: 400;">Hirschsprung Disease</li>
<li style="font-weight: 400;">Cystic Fibrosis</li>
</ol>
</li>
</ol>
</li>
</ol>
</li>
<li style="font-weight: 400;">Assess Nutrition
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Fiber intake</li>
<li style="font-weight: 400;">Fluid intake </li>
</ol>
</li>
<li style="font-weight: 400;">Assess for environmental psychosocial causes 
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Illness</li>
<li style="font-weight: 400;">Fear of using public toilets</li>
<li style="font-weight: 400;">Fear of painful bowel movements</li>
</ol>
</li>
</ol>
<h4>Therapeutic Management</h4>
<ol>
<li style="font-weight: 400;">Increase fluid and fiber in diet</li>
<li style="font-weight: 400;">Establish healthy bowel habits
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Positive reinforcement
<ol style="list-style-type: lower-roman;">
<li style="font-weight: 400;">Star charts</li>
</ol>
</li>
</ol>
</li>
<li style="font-weight: 400;">Administer enemas if required
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Monitor electrolyte balance</li>
</ol>
</li>
<li style="font-weight: 400;">Administer stool softening agents
<ol style="list-style-type: lower-alpha;">
<li style="font-weight: 400;">Docusate</li>
<li style="font-weight: 400;">Lactulose</li>
<li style="font-weight: 400;">Polyethylene glycol  (Miralax)
<ol style="list-style-type: lower-roman;">
<li style="font-weight: 400;">Best tolerated by children</li>
<li style="font-weight: 400;">Mix with beverage of choice </li>
</ol>
</li>
</ol>
</li>
<li style="font-weight: 400;">Develop bowel protocol</li>
</ol>
<h4>Nursing Concepts</h4>
<ol>
<li style="font-weight: 400;">Elimination</li>
<li style="font-weight: 400;">Gastrointestinal/Liver Metabolism</li>
<li style="font-weight: 400;">Human Development</li>
</ol>
<h3>Patient Education</h3>
<ol>
<li style="font-weight: 400;">Increase fluids and fiber in diet</li>
<li style="font-weight: 400;">Bowel protocol</li>
<li style="font-weight: 400;">Seek therapy if related to fear of defecating in public</li>
</ol>
References:
Hockenberry, M., Wilson, D. &amp; Rodgers, C. (2017). Wong’s essentials of pediatric nursing (10th ed.) St. Louis, MO: Elsevier Limited.  
Lissauer, T. &amp; Carroll, W. (2018). Illustrated textbook of pediatrics (5th ed.) Europe: Elsevier Limited.

Pediatrics

06-09-constipation-and-encopresis

06.09 Constipation and Encopresis (Incontinence)

In this course, you'll be able to learn different mnemonics that will help you to remember the need to know nursing information!

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Aortic Aneurysm – Management Nursing Mnemonic (CRAM)

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Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)

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Aortic Stenosis Symptoms Nursing Mnemonic (SAD)

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Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)

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Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)

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Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)

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Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)

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Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)

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CHF Treatment Nursing Mnemonic (UNLOAD FAST)

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Cyanotic Defects Nursing Mnemonic (The 4 T’s)

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Heart Failure-Left-Sided Nursing Mnemonic (CHOP)

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Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)

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Heart Failure – Right Sided Nursing Mnemonic (HEAD)

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Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)

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Hypertension- Complications Nursing Mnemonic (The 4 C’s)

nursing-mnemonics-diuretic

Hypertension – Nursing care Nursing Mnemonic (DIURETIC)

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Increase MAP Nursing Mnemonic (VAK)

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Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)

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Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)

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Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)

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Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)

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Vasospasm Therapy Nursing Mnemonic (Triple H Therapy)

Cardiovascular (Cardiac, CVD) Mnemonics

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Anion Gap Acidosis 1 Nursing Mnemonic (KULT)

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Anion Gap Acidosis 2 Nursing Mnemonic (MUDPILES)

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Arterial Blood Gases Nursing Mnemonic (ROME)

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Blood Type O Nursing Mnemonic (Universally Odd)

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Electrolytes – Location in Body Nursing Mnemonic (PISO)

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Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)

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Hyperkalemia – Causes Nursing Mnemonic (MACHINE)

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Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)

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Hyperkalemia – Management Nursing Mnemonic (AIRED)

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Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)

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Hypernatremia – Causes Nursing Mnemonic (MODEL)

nursing-mnemonics-salt

Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)

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Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)

nursing-mnemonics-tired

Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)

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Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)

nursing-mnemonics-salt-loss

Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)

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Vitamins – Fat Soluble Nursing Mnemonic (All Dogs Eat Kibble)

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Vitamins – Water Soluble Nursing Mnemonic (Birth Control)

Electrolytes & Labs Mnemonics

nursing-mnemonics-batted

ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)

nursing-mnemonics-beep

Bleeding Complications (Minor) Nursing Mnemonic (BEEP)

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Mnemonic for Organ Systems (MR DICE RUNS)

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Bleeding Precautions Nursing Mnemonic (RANDI)

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Canes Nursing Mnemonic (COAL)

nursing-mnemonics-clpn

Caring Licensed Practical Nurse Nursing Mnemonic (CLPN)

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CHO, CHO, CHON Nursing Mnemonic (CHO, CHO, CHON)

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Community Health Tool Nursing Mnemonic (MAP-IT)

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Environmental Health Assessment Nursing Mnemonic (I PREPARE)

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Exercise Guidelines Nursing Mnemonic (FIT)

nursing-mnemonics-pass

Fire Safety 1 Nursing Mnemonic (PASS)

nursing-mnemonics-race

Fire Safety 2 Nursing Mnemonic (RACE)

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Gluten Free Diet Nursing Mnemonic (BROW)

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High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)

nursing-mnemonics-scum

IADLS (Instrumental Activities of Daily Living) Nursing Mnemonic (SCUM)

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Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)

nursing-mnemonics-cake-everyday

Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)

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Pain Assessment Questions Nursing Mnemonic (OPQRST)

nursing-mnemonics-precede-proceed

Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)

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Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)

nursing-mnemonics-perrla

Pupil Reactions Nursing Mnemonic (PERRLA)

nursing-mnemonics-madle

Safety Check Nursing Mnemonic (MADLE)

nursing-mnemonics-sbar

SBAR Communication Nursing Mnemonic (SBAR)

nursing-mnemonics-soapie

Steps In The Nursing Process 3 Nursing Mnemonic (SOAPIE)

nursing-mnemonics-fast

Stoke Assessments Nursing Mnemonic (FAST)

nursing-mnemonics-adpie-a-delicious-pie

Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)

nursing-mnemonics-aapie-an-apple-pie

Steps in the Nursing Process 2 Nursing Mnemonic (AAPIE)

nursing-mnemonics-abcdefghi

Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)

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Trauma – Complications Nursing Mnemonic (TRAUMATIC)

nursing-mnemonics-ample

Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)

nursing-mnemonics-start

Triage Nursing Mnemonic (START)

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Walkers Nursing Mnemonic (Wandering Wilma Always Late)

old-carts

OLD CARTS Mnemonic (OLD CARTS)

Fundamentals & Nursing Process Mnemonics

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Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)

nursing-mnemonics-pains

Appendicitis – Assessment Nursing Mnemonic (PAINS)

nursing-mnemonics-bulimia

Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)

nursing-mnemonics-washed

Bulimia – Signs and Symptoms 2 Nursing Mnemonic (WASHED)

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Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)

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Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)

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Causes of Pancreatitis Nursing Mnemonic (BAD HITS)

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Diarrhea – Treatment Nursing Mnemonic (BRAT)

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Diverticulitis Complications Nursing Mnemonic (Please Fix His Abscess SOon)

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Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)

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GERD causes Nursing Mnemonic (Reflux Is Probably Mean)

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Hiatal Hernia Symptoms Nursing Mnemonic (Her Belly Really Hurts Following Dinner)

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Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)

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Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)

Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)

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POOPER SCOOP

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Nursing Mnemonics

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