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o Color - Brown, darkens with standing o Consistency - Formed, semi-solid mass o Amount - Described as small, moderate, or large. Typically 150 g/day o Odor - Varies with pH; caused by bacterial action in the GI tract o Usually one bowel movement each day, varying with the patient o 70% water

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Normal stool

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Brown, darkens with standing

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Normal stool Color

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Formed, semi-solid mass

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Normal stool`Consistency

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Described as small, moderate, or large. Typically 150 g/day

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Normal stool Amount

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Varies with pH; caused by bacterial action in the GI tract

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Normal stool Odor

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Usually one bowel movement each day, varying with the patient

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Normal stool bowel movement

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How much Water is in a Normal stool

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70% water

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Normal stool Amount

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150 g/day

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Watery stool may indicate irritation or infection of bowels and result in fluid loss. Hard stool may indicate constipation

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Abnormal stool Consistency

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More than 3 times a day or less than once a week

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Abnormal stool Frequency

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Any presence of blood, pus, mucus, worms and excess fat is not normal

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Abnormal stool

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colored may indicate an absence of bile, and may be a sign of gallbladder or liver disease

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White or clay Abnormal stool Color

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may indicate upper GI bleeding (e.g., peptic ulcer disease)

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Black or "tarry" color

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may indicate lower GI bleeding (e.g., hemorrhoids or Diverticulitis)

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Bright blood

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may indicate malabsorbtion of fat

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Pale with fat

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may indicate spastic constipation, colitis and excessive straining

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Translucent mucus

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may indicate blood in feces, inflammation and infection

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Bloody mucus

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may indicate irritation or infection of bowels and result in fluid loss.

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Watery stool

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may indicate constipation

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Hard stool

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to analyze for abnormal components and parasites

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Stool Specimen collection

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o Bedpan/portable commode o Toilet paper o Lab request form. Depends on test ordered o Tongue blades o Clean stool specimen container and label o Sterile specimen container is indicated only for culture and sensitivity o Clean gloves

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Stool Specimen collection equipment

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If patient passes blood, mucus, or pus with stool,

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include in specimen

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Make sure the stool specimen is not contaminated with

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urine or toilet paper

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Collect at least 1 inch of formed stool

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Collect 1 inch of formed stool

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of liquid diarrhea stool

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Collect 15-30 mL

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o Nursing Note SF 510 Color, character, and amount of stool Test requested Disposition of specimen o Patient Profile NAVMED 6550/12 or Air Force Inpatient Flowchart Date specimen sent to lab o 24-Hour Intake and Output Worksheet DD Form 792 if indicated

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Stool Specimen collection Record procedure

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May be performed on ward or sent to lab. Check local policy Specimen is tested to determine presence of occult (hidden) blood. It is also known as a hemoccult or occult blood test

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Testing stool for occult blood

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o Hemoccult slide o Hemoccult developing solution o Wooden applicator or tongue blade o Clean gloves

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equipment needed Testing stool for occult blood

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o Check expiration date of developing solution o Perform hand hygiene and don gloves o Collect a small specimen of stool with an applicator or gloved o Hemoccult can also be performed on other specimens such as NG aspirate o Apply thin smear of stool on the first box of the guaiac paper o Apply a second thin smear from a different portion of stool on the second box of the guaiac paper o Close slide cover and turn over to develop o After 3-5 minutes, open cardboard flap and apply two drops of developing solution on each smear and 1 drop on the center of the control strip

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Testing stool for occult blood Procedure

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(hidden) blood It is also known as a hemoccult or occult blood test

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occult

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Hemoccult can also be performed on other specimens such as

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NG aspirate

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Apply thin smear of stool on the first box of the guaiac paper

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Apply thin smear of stool on the first box

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Apply a second thin smear from a different portion of stool on the second box of the guaiac paper

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Apply a second thin smear from a different portion of stool on the second box

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After 3-5 minutes, open cardboard flap and apply two drops of developing solution on each smear and 1 drop on the center of the control strip

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After 3-5 minutes

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Bluish ring surrounding specimen on slide - Positive guaiac or hemoccult, sample contains blood No color change is noted on slide - Negative guaiac or hemoccult, sample does not contain blood

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Read results within 60 seconds

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Positive guaiac or hemoccult, sample contains blood

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Bluish ring surrounding specimen on slide

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Negative guaiac or hemoccult, sample does not contain blood

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No color change is noted on slide

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How fast should the Control strip is used to verify a valid test?

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60 seconds

2.1.5 Stool Specimens

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