Gastro 1 Flashcards
Cathartic
Medication that makes patient vomit / have diarrhea
Colonic irrigation
Washing out of the colon
What are the 4 main functions/ steps of the gastrointestinal tract?
Ingestion
Digestion
Absorption
Elimination
Ingestion
Occurs in the mouth - mechanical breakdown of nutrients
Digestion
In stomach
- mechanically/ chemically prepares food for uptake by bodies cells
Absorption
Small intestine - absorbs digested food and transfers nutrients to circulation
What step of the Gi tract maintains fluid and electrolyte balance
Absorption
Elimination
Large intestine - eliminates of waste by defecation
Gastric mobility
Stomach secretes large volumes of gastric juices
Mucus
Hydrochloride acid
Pepsin
Intrinsic factors
Gastroferrin
Steps of gastric motility
Swallowing
Esophageal peristalsis
Stomac secretes juices
Gastric emptying
Intestinal mobility
Movements of small intestine facilitate digestion and absorption of nutrients
Parts of small intestine
Duodenum
Jujunum
Ileum
Liver function
Produce bile to absorb fat soluble vitamins
Metabolize fats
Metabolize proteins
Carbs
Metabolic detoxification
Pancreas functions
Secrete enzymes & alkaline fluids to help in digestion
Gallbladder function
Store and concentrate bile between meals
What are some factors that affect normal bowel function?
Age
Diet!!
Physical activity
Psychological factors
Personal habits - eating late
Meds
What are some common gIsymptoms will you see in an older adult?
Decreased gastric motility
Decreased secretions from small intestine
Decreased liver size/function
Decreased enzyme production
Sense of smell decreases
Decrease taste buds
Teeth lost
What needs to be done during a assessment of the Gi system?
Health history / med history
Height / weight
Mouth
Abdomen- listen to bowels then palpate
Bristol stool chart
The standard of typing a persons stool
What are the 2 classifications of gi conditions
Non inflammatory
Inflammatory
Non inflammatory are considered
Constipation
Diarrhea
Incontinence
Hemorrhoids
Gerd
Ibs
Inflammatory acute
Appendicitis
Peritonitis
Gastroenteritis
Cholecystitis
Chronic inflammatory GI
Crohn’s disease
Diverticulitis
Ulcerative colitis
Gastritis
Breakdown of normal mucosal barrier that protects stomach from HCl - causing stomach lining to become inflamed
Common causes for gastritis
Meds like nsaids
H pylori
Treatment for gastritis
Eliminate meds/foods that cause it
Administering h2 blockers
Upper gi bleeds are found where
Stomach up
Severity of upper gi bleed
Loss of more than 1500 ml/ 25% of blood
Hematemesis
Frank blood
Or coffee ground emesis from stomach
Melena
Black tarry stools
Causes of UGIB
Food
Alcohol
Tumor s
Meds
Pud
Esophageal caprices
Esophageal varices
Little tears that can cause hemorrhaging
Lab diagnostics for UGIB
CBC
Bun
Pt/ ptt
Liver function
What are nursing care for UGIB
Monitor shock secondary to gi bleed
I/o s
Abdominal exam
Fluid resuscitation/ prep for blood transfusion
Peptic ulcer
Erosion of the gi mucosa by HCl acid and pepsin
Acute ulcer
Superficial erosion and minimal inflammation
Chronic ulcer
Erodes through muscular wall
- can be intermittent throughout patients life
Causes of peptic ulcers
Stress
Smoking
Medications
Psych distress
H pylori
Duodenal ulcer
Most common type
- caused by a disease
How to test for ulcers
Blood test
- cbc - ammonia
Amylase
Pylori test - c urea breath test
How are ulcers treated
Rest
Diet modification- - 6 small meals a day
Medications
STOP nsaid use!!
Common drugs for h pylori
Ppi reduces acid
Antibiotics - eliminates it
Ppi and antibiotics
What are some complications from ulcers
Hemorrhage
Perforation - hurting allowing bacteria to spread
Smoking - delayed healing
What are the type of Ulcer surgeries
Billroth 1
Billroth 2
Billroth 1
Gastroduodenostomy
Stomach to dueodenum
Billroth 2
Gastrojejunosromy
Stomach to jejunum
Dumpling syndrome
Surgery reduces reservoir capacity of stomach and control of fluid entering small intestine
- goes directly through
Biggest sign of dumping syndrome
Loud bs
- going to the bathroom right after eating
Treatment for dumping syndrome
6 small meals / day
No fluid w/ meal
Avoid sweets
Food borne illness commonly caused by
E. coli
- due to undercooked meats and contaminated fruits/ veggies
Gerd
Reflex of gastric secretions into esophagus
Treatment for Gerd
Weight loss
No smoking
No nsaid use
Head of bed raised during meals
Four types of medications given for Gerd
H2 blockers
Ppi
Protectant
Prokinetic
H2 blockers
- decrease acid secretion
Ranitidine
Cimetidine - Tagamet
Famotidine - Pepcid
Ppi
Inhibit production of HCl
Omeprazole (Prilosec)
Esomeprazole - nexium
Pantoprazole - proton is
Protectant
Coats stomach
Sucralfate- carafate
Prokinetic
Increase gastric motility
Metoclopramide - raglan
Constipation
No BM in 3 days
Types of enemas
Tap water
Normal saline
Cleaning
Soap sud
Tap water enema
Erects lower osmotic pressure
Cleaning enema
Cause irritation by causing normal saline / soap suds to stimulate peristalsis
Oil retention enema
Lubricates to make stool to come out easier
Bulk forming laxatives
Increase water in intestine
Type of bulk forming laxative
Metamucil
Lubricants
Coats feces making it easier to pass
- decrease in water and decrease absorption of fat soluble vitamins
Stool softeners
Pull water into stool
Example of stool softeners
Docucate sodium - colace
Cathartics
Stimulate bowels
- cause peristalsis
Example of cathartic
Senna
Dulcolox
Castor oil
Saline laxatives
Osmotic effect that draws water into bowel
- stimulates peristalsis and lubricants
Example of saline laxative
Milk of mag
Diarrhea is considered the passage of
3 or more loose stools
What causes c diff
Use of a long spectrum antibiotic that alters flora
Treatments for diarrhea
Fluid replacement - electrolytes !!
Antibiotics
What is the common antibiotic given for c diff
Flagella - metronidazole
Flatulence
Abdominal fullness , pain and cramping from reduction in motility
Emesis
Nausea and vomiting
What do you need to take in to account when emesis is happening?
Color
Time of day
Stress
Medications given for emesis
Campazine - phenergan
Raglan
Zofran
Dronabinol
What should you consider post n/v of older adults?
Rehydration - fluid loss
Electrolytes- loss
Cardiac function - loss of potassium
Risk for falls - meds
What are some nursing considerations for nasogastric decompression
Frequent ambulation
Encourage fluids
Slow diet advancement
