Chapter 38 / 39: Assessment of Digestive and GI function Flashcards by Makieah Mack

Digestions begins with ________ where food is broken down into small particles that can be swallowed and mixed with _____________ ________

chewing
digestive enzymes

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Absorption is a MAJOR function of the ______ intestine — vitamins and minerals are absorbed, accomplished by _________ transport and _________ across intestinal walls into the circulation

small
active
diffusion

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elimination is the phase of the digestive process that occurs after digestion and absorption when _______ products are eliminated from the body

waste

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salivary amylase breaks down :
Pepsin breaks down:
intrinsic factor is needed to absorb _____
lipase breaks down:
trypsin breaks down :
Bile breaks down :

startches
protein
b12
fat
protein
fat

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Chyme is broken down ________ and __________ acid

food
stomach

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emulsification is the breakdown of ____

fat

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peristalsis is the constriction of ________ muscles that promotes wavelike movement to push stomach contents _________

stomach
forward

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Key parts of the GI system assessment

Health Hx
-pain, indigestion, gas, N/V, diarrhea, constipation, previous GI disease

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What is included in the physical assessment of the GI system

Oral cavity
- lips, gums, tongue
Abdominal assessment (4 quad method) IAPP

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Diagnostic studies and tests for GI
stool tests : ________ blood test (must be obtained on __x on different days to confirm blood occult)
Breath tests : __ ________ testing
________ and ________ tract study
GI ________ study
Endoscopic procedures
CBC
Coag studies ( to look for ________)
Culture

occult ,3
H. Pylori
Upper and Lower
motility
bleeding

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Parotitis is the inflammation of the ________ gland. is the most ________ inflammation condition of salivary glands

parotid
common

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what are some symptoms of parotitis?

Fever
chills
systemic signs of infection

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what is the medical management of parotitis?
* adequate _____________/_______ intake
* good _______ care
* ______packs
* Stop meds that decrease ____________ (steroids, anti-inflammatory)

nutritional/ fluid
oral
cold
salivation

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Sialasentitis is the inflammation of the ___________ glands - may be caused by:
* Dehydration
* ___________ therapy
* Stress
* Malnutrition
* salivary gland _________
* Improper _______ hygiene

salivary
radiation
calculi
oral

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what are some signs and symptoms of sialadenitis

pain
swelling
purulent drainage

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how do you treat/manage sialadentitis?

massage
hydration
warm compress
sialagogues ( anything that stimulates salivation)

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Sialolithiasis are salivary _________ (stones)

calculi

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What are the symptoms of salivary stones?

local sudden pain —relieved by gush of saliva

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How are salivary stones managed/treated?

Sialendscopy ( standard treatment)
Lithotripsy

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Neoplasms are salivary _________/________

tumors/growths

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what are some risk factors of neoplasms?
* ___________ to the head and neck
* __________ age
* exposure to specific ____________ in the work environment

radiation
increased
carcinogens

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how are neoplasms treated/managed?

radiation
chemo
surgery

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What are some risk factors for oral cancer?

tobacco use
HPV infection
Alcohol
HX of head/neck cancer

what are early manifestations of oral cancer?

often few/no symptoms
painless mass/sore that doesn’t heal

Any lesion present for more than 2 weeks or does not heal should be examined and biopsied (TRUE OR FALSE)

True

what are some late manifestations of oral cancer?

complaints of soreness difficulty swallowing, chewing, speaking

what are the treatments/Management for oral cancer?

surgical resection (removal) Radiation therapy (localized) Chemo (systemic)

_______ neck dissection is used the ________ - it removes lymph nodes, sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve

radical most

_________ neck dissection removes structures such as lymph nodes and tumor

modified

some pre-op care for neck dissections include : * assess _________ prep and _________ * make sure pt _____________ procedure and what they should _______ afterwards

physical and knowledge understands, expect

some post-op care for neck dissection includes : * assess for _____________ related to : * airway and breathing * infection * Hemorrhage * Other : _______ injury , ______ leak

complications nerve, chyle

Nursing interventions for Neck dissection * maintain _________ clearance * ________ position * deep __________ * assess and manage _____ *Maintain adequate ___________

airway fowler breathing pain nutrition

a _______ ________ is where the opening in the diaphragm through which the esophagus passes becomes enlarged, and part of the upper stomach moves up into the portion of the thorax

hiatal hernia

___________ and _______________ are the two main types of hiatal hernias

sliding and paraesophageal

sliding hiatal hernias occur when the upper _________ and the _________________ junction are displaced upward and slide in and out of the thorax

stomach gastroesophageal *** most common type

A paraesophageal hernia occurs when all or part of the stomach pushed through the __________ beside the ___________

diaphragm esophagus

what are some signs and symptoms of sliding hiatal hernias?

heartburn reflux chest pain ***dysphagia belching ***pyrosis **regurgitation **** many pts are asymptomatic

what are some common signs and symptoms of paraesophageal hiatal hernias?

**hemorrhage **obstruction **volvulus **strangulation feeling fullness after eating chest pain

what are some risk factors of hiatal hernias high intake of _______ foods _________ or ___________ right before bed

fatty eating or drinking

management for hiatal hernias includes : *frequent small _______ * pt is advised to not _______ for 1 hour after eating to prevent reflux/ movement of hernia * PPIs : reduce ______ ____ by inhibiting cellular pump or gastric parietal cells necessary for gastric and acid secretion ( omeprazole , Panprozol ) * Antacids : _________ excess acid and increases LES pressure (TUMs, Pepcid) ** take 1-2 hours before eating

meals recline gastric acid Neutralizes

GERD is a fairly common disorder marked by the backflow of _______ or duodenal contents into the esophagus

gastric

GERD may occur because of an incompetent lower esophageal ___________, pyloric _______, hiatal _______, or ________ disorder

Sphincter stenosis hernia motility

common risk factors of GERD: * _________ use *__________ drinking * _________ consumption * increased ________ *sleep ____ * ________ age * _________ infection w helicobacter pylori

tobacco caffeine alcohol weight apnea increased gastric

clinical manifestation of GERD include * heartburn (may ________) * ___________ at midline *_______salivatio n (can mimic heart attack ) * Nocturnal - cough, wheeze, SOB, ______ sleep patterns

radiate dyspepsia hyper disturbed

how do you treat/manage GERD? * avoid esophageal _________ *lifestyle modifications — (_________, ______ ______) * ________ HOB 30 degrees, assess lung sounds, prevent aspiration *Nutritional diet - low ____ diet Avoid caffeine, peppermint or spearmint, beer, milk, carbonated beverages * Meds: PPIs and H2 receptors

irritants smoking, losing weight elevate

complications of GERD are: * aspiration *esophagitis *** Barrett’s esophagus : ____________ cell _________

reversible, changes

what are some risk factors of esophageal cancer?

GERD BE nutritional deficiency tobacco use alcohol use

what are some clinical manifestations of esophageal cancer? ** feeling that food is not ___________ _________ or sensation of ________ ___ _________ * sore throat or __________ *Dysphagia * Weight ______ * Choking and/or _____________

passing through, mass in throat hoarseness gain regurgitation

what is some pre-op care for esophageal cancer? *______ calorie and _____ protein diet * IV fluids _________/ chemotherapy * Meticulous ______ care

high, high radiation oral

what is some post-op care for esophageal cancer? HOB elevated ___ degrees _____ - no manipulation by RN; monitor for arrhythmias When able to eat, diet as tolerated; risk for ___________ syndrome

30 NGT Dumping

Delivering nutrition enterally is done to meet ___________ requirements when oral intake is inadequate or not possible, but GI tract is functioning

nutritional

what are some of the advantages of delivering nutrition enterally? * _____ and ______ effective * Preserve GI ___________ * Preserve _______ sequence of intestinal and hepatic metabolism * Maintain fat _____________ and lipoprotein synthesis * Maintain __________ insulin and glucagon ratios

safe and cost integrity normal metabolism normal

what are some of the most common complications of enteral nutrition ?

Overfeeding reseeding syndrome aspiration pneumonia constipation Diarrhea

reasons for tube feeding: * pt cannot __________ * something in the ________ tract (mouth , throat ) needs to be bypassed

swallow upper

What are some reasons to have a g tube or j-tube?

difficulty swallowing difficulty digesting food removal of part of the GI