a. General. Stool samples can be examined on the ward and in the laboratory to determine the presence of substances that aid in diagnosis. For example:

(1) On the ward, nursing personnel can determine the color, consistency, and amount of stool. The presence of unseen blood (occult) can be determined with a simple test.

(2) In the laboratory, tests can be performed to determine the presence of fat, urobilinogen, ova, parasites, bacteria, and other substances.

b. Nursing Implications.

(1) Nursing personnel should consider the following information when assessing and documenting information related to a patient’s bowel movements.

(a) Small, dry, hard stools may indicate constipation or fecal impaction.

(b) Diarrhea may indicate fecal impaction or fecal mass, or it may be the result of a disease process (such as colitis or diverticulitis) or a bacterial infection (such as dysentery).

(2) Nursing personnel should consider the patient’s diet when assessing and documenting the character of a patient’s stool.

(a) Black, tarry stools may be the result of upper GI bleeding, iron supplements, or diet selection (eating black licorice, for example).

(b) Reddish colored stools may be the result of bleeding in the lower GI tract or diet selection (eating carrots or beets, for example).