Chapter 52 Flashcards
What is the Alimentary canal
The mouth pharynx esophagus stomach small intestine large intestine in the rectum.
Structure of inner wall
There are four layers and closer submucosa muscularis and serosa the mucosa is there animals layer
Function of the GI tract
Secretion digestion absorption motility and illumination
Saliva
Saliva is secreted in response to the presence of food in the mouth and begin to soften the food.
saliva contains making an enzyme called the Library Emilys also known as Ptyalin which begins the breakdown of carbohydrates
Stomach location
The stomach is located midline and the left upper quadrant of the dominant and has or anatomical regions.
Four regions of the stomach
The cardia upper portion near GE.
The fund us.
The main area of the stomach is the body of corpus.
The entrance or pylorus is the distal lower the portion of the stomach and separate it from the duodenum by the plyoric at Spencer
The pancreas function and structure
The pancreas is a fish shaped gland that lies behind the stomach and extends horizontally from the duodrnal C loop to the spleen .
exocrine and endocrine functions did the hormones are a essential in the regulation of metabolism.
A dual or in the head of the pancreas lies in the curvature of the duodenum
Pancreas exocrine enzymes
Trypsin digest proteins and Chymotrypsin
Amylase digest carbohydrates
Lipase digestion of fats
The Liver Structure and location
Largest GI organ. In Upper right quadrant mostly
Liver Function
Performs more than 400 functions in storage protection and metabolism and stores minerals vitamins such as iron magnesium fat vitamins A D E K
Ileocecal valve
Separates the entrance of the ileum from the cecum of the large intestines
Large intestines
I’m about 5 to 6 feet in length. starts with the cecum and ends with the anal canal
Function of the large intestines
Movement absorption and illumination consist of segmental contractions.
water is absorbed and electrolytes
food is stored in to in the rectum
Small intestine function
With me digestion and absorption it takes 3 to 10 hours for the contents to be passed by Peristalsis
Age related changes by a trophy of Cass Technical so decrease hydrochloric acid levels
This is called Hypochlorhydia.
A decrease absorption of iron and vitamin B 12 A. Moore bacteria. Atrophic gastritis occurs as a consequence of bacteria overgrowth.
Age related changes of decreasedperistalsis and the nerve impulses?
A decreased sensation to defecate leading to constipation
Age related changes of the older adult, distention and dilation of the pancreatic duct change. decrease in lipase production cause calcification.
A decrease in Lipase level results in decreased fat absorption and digestion steatorrhea or excess fat in the feces occurs because of decreased fat digestion
Age related changes in the number size of heptic cells. decreased liver weight and mass.
Decreased enzyme activity depresses drug metabolism which leads to accumulation of drugs possibly to toxic levels.
Body structures of the right upper Quadrant
Most of the liver Gallbladder duodenum the head of the pancreas heptic flexure of the colon part of the ascending and transverse colon
Location body structures of the left upper quadrant
Left lobe of the liver stomach spleen body and tail of the pancreas splenic future of the colon part of the transverse and descending colon
Midline location of the abdominal
Abdominal aorta
the uterus if it’s enlarged
the bladder if it’s distended
Location of the right lower quadrant of the abdominal
RLQ
Cecum
appendix
right ureter
right ovary and fallopian tube
right spermatic cord
Abdominal structure of the lower left quadrant. LLQ
Part of the descending colon
Sigmoid colon
left ureter left ovary fallopian tube
left spermatic cord
How do you prepare a client for abdominal assessment?
First have the patient empty their bladder then ask him to lie in the supine position with the knees bent and keep the earth at the side to prevent tension of it myself.
Sequence of abdominal assessment
Expections also Tatian in light palpitations. A PRN does precaution and deep palpitations.
If appendicitis or a down on aneurysm is suspected papa Tatian it’s not done
Normal bowel sounds
High pitch irregular gurgles every 5 to 15 seconds or 5 to 30 per minute.
When taking a history for a patient with G.I. problems which daily client behavior requires for the nursing assessment select all that apply
Take 800 mg of ibuprofen for arthritis pain
takes SeNna to assist with bowel movements
Chews tobacco
The nurse is performing a physical assessment on a clients abdominal. the nurse inspects and find it a symmetrical with a non-pulsating mass in the right upper quadrant what is the priority
Auscultation for bowel sounds and bruits
And there’s is the parent of a teaching session about early detection of colorectal of cancer which test you the nurse include
Colonoscopy every 10 years
Flexible sigmoidoscopy every 5 years
Stool DNA test SDNA every 3 years
double contrast barium enema every 5 years
Take home yearly GFOBT
Pancreatitis lab assessment
Decreased calcium 9.0-10.5
increased serum Amylase 30-220
increase lipase 0-160
increase cholesterol 200+
Increased carbohydrate antigen 19.9 greater than37
Pancreatic cancer lab assessment
Increased CAE greater than 5
Increased carbohydrate antigen should be less than 37
Gallbladder lab Assessment
Increased alkaline phosphatase
increased bilirubin
increase conjugated direct bilirubin
increase cholesterol
EGD use for?
A visual exam of the esophagus stomach and duodenum
Stop G.I. bleeding
Visualize gastric lesions
treat esophageal stricture dilation
visualize and confirm celiac disease
Explaination E.g. D procedure
A visual exam of the esophagus stomach and the duodenum.
A informed consent is required
A flexible fiberoptic tube is passed down the esophagus while under moderate sedation also anesthetic spray is used to stop the gas reflex atropine is used to dry secretions
What position should the patient lying in for EGD test
Live with the head of the bed elevated with a fight block in your mouth it’ll take 20 to 30 minutes for the procedure
Role of the nurse during a EGD test
Monitor the respirations for a rate and depth
monitor oxygen
Use pulse ox saturation may use capnography for hypoxemia
Post test for EGD
Monitored vitals every 15 to 30 minutes until sedation wears off
raise the side rails
NPO until gag reflex returns
disconnect IV fluids when the patient can tolerate fluids w/o nausea vomiting
Has someone to drive them home
Do not drive for 12-18 hours
Hoarse voice or sore throat for days after
Use lozenges for throat discomfort
Patient teaching for a EGD test/ Pre Op
NPO 6 to 8 hours before
take hypertension meds or Chronic med morning of test
avoid NSAIDs anticoagulants aspirin several days before the test
DM med consult the healthcare provider
Gag reflex will be depressed and swallowing will be difficult
Remove dentures
Endoscopic retrograde cholangiopancreatography
ERCP test?
Includes a visual and radiographic examination of the liver gallbladder gold ducts and pancreas to identify the cause and location of OBSTRUCTION.
Patient teaching for ERCP
Ask a patient if they have a implantable medical device such as a cardiac peacemaker defibrillators will need to be deactivated
Remove dentures
if they have an allergic to contrast medium let them know that a contract medium will be injected
the patient with the place on the left lateral position to view bile duct
Tilt table is used/ pt in prone position
examination takes 30-2 hours
What is a colonoscopy
Endo scopic exam of the entire large bowel
What is the gold standard test for detecting colon cancer?
Colonoscopy.
everyone should have a colonoscopy at age 50 and then every 10 years after
Uses for colonoscopy
Chronic diarrhea sort of G.I. bleeding for tissue biopsy or to remove a polyp the test takes 30 to 60 minutes
Normal to expect after colonoscopy
Feeling of fullness
cramping
flatus
small blood in first stool if the biopsy was done
What is thePriority care to promote patient safety after EGD/ERCP?
Prevent aspiration by checking gag return
do not offer fluids or food by mouth until you are sure gag reflex is intact
monitor for signs of perforation;PAIN FEVR BLEEDING
What severe complications to monitor for after EGD/ERCP 2 days later?
Severe pain
fever indicate sepsis
Monitor for gallbladder inflammation perforation sepsis and pancreatitis appear hours to two days after test
