616 UNIT VI / Responses to Altered Bowel Elimination

■ Assessing Stool Characteristics

Inspect feces for color, odor, and consistency after the rectal exam
or after defecation. Both hands are gloved.
COLOR
■ Blood on the stool results from bleeding from the sigmoid
colon, anus, or rectum. Blood within the stool indicates bleed-
ing from the colon due to ulcerative colitis, diverticulosis, or tu-
mors. Black, tarry stools, called melena, occur with upper gas-
trointestinal bleeding. Oral iron may turn stools black and
mask melena.
■ Grayish or whitish stools can result from biliary tract obstruc-
tion due to lack of bile in stool.
■ Greasy, frothy, yellow stools, called steatorrhea, may appear
with fat malabsorption.
ODOR
■ Distinct, foul odors may be noted with stools containing blood
or extra fat or in cases of colon cancer.
CONSISTENCY
■ Hard stools or long, flat stools may result from a spastic colon
or bowel obstruction due to a tumor or hemorrhoids. Hard
stools may also result from ingestion of oral iron.
■ Mucousy, slimy feces may indicate inflammation and occur in
irritable bowel syndrome.
■ Watery, diarrhea stools appear with malabsorption problems,
irritable bowel syndrome, emotional or psychologic stress, in-
gestion of spoiled foods, or lactose intolerance.

Fecal Assessment with Abnormal Findings
• Inspect the client’s feces. After palpating the rectum, with-
draw your finger gently. Inspect any feces on the glove. Note
color and/or presence of blood. Also use gloved fingers to
note consistency.
✓ See Box 23–1 for information about stool characteristics.
• Test the feces for occult blood. Use a commercial testing kit.
✓ A positive occult blood test requires further testing for
colon cancer or gastrointestinal bleeding due to peptic ul-
cers, ulcerative colitis, or diverticulosis.
• Note the odor of the feces.
✓ Distinctly foul odors may be noted with stools containing
blood or extra fat or in cases of colon cancer.

EXPLORE MediaLink
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