Gastrointestinal System Flashcards
Functions of the pancreas
Exocrine: acinar cells secrete inactivated enzymes that travel to the small intestine and become activated to help digest carbohydrates, fats, and proteins
Endocrine: Islets of Langerhans cells regulate blood glucose levels through hormones like glucagon and insulin
Functions of the liver
Storage of minerals and fat soluble vitamins, bile production and secretion, Bilirubin metabolism and secretion, detoxification of harmful drugs and substances, plasma protein synthesis (albumin and clotting factors), fat metabolism including cholesterol synthesis and elimination, carbohydrate metabolism (ex: glycogenolysis is the breakdown of glycogen which is stored carbohydrate energy in the liver)
Function of gallbladder
Storage and concentration of bile from the liver
Esophagogastroduodenoscopy (EGD)
Done under moderate sedation, scope, inserted down the throat and esophagus, stomach, and the duodenum are visualized, patient must be NPO 6 to 8 hours prior to the procedure, no bowel prep needed for procedure
Sigmoidoscopy
Visualizes the anus, rectum, and sigmoid colon; no anesthesia required, patient will need to be NPO after midnight before the procedure, patient will need to drink polyethylene glycol to clean out bowels (bowel prep)
Colonoscopy
Performed under moderate sedation, visualizes the anus, rectum, Sigmoid colon, descending colon, transverse colon, and ascending colon; patient will need to be NPO after midnight and will need to consume polyethylene glycol for bowel prep
GI series
used to identify GI abnormalities, such as an ulcer, tumor or obstruction; patient will drink barium and x-rays are taken as barium moves through GI tract; patient will need to be NPO for eight hours prior to the procedure, educate patients not to smoke or chew gum for eight hours prior to the procedure, after the procedure encourage patient to increase fluid intake to flush out barium, inform patient that stools will be white in color for several days until barium is cleared out
Level one Dysphagia diet
All food puréed and thickened liquids
Level two and three Dysphagia diet
Soft and moist foods
Dysphagia nursing care
Sit the HOB up when eating, teach patient to tuck their chin against their chest when swallowing
Backflow of gastric contents into the esophagus due to relaxation or weakening of lower esophageal sphincter, causing pain and mucosal damage leading to esophagitis and Barrett’s esophagus (high risk for esophageal cancer)
GERD
GERD risk factors
Obesity, smoking, alcohol use, older age, pregnancy, ascites, hiatal hernia
S/S of GERD
Dyspepsia (indigestion), throat irritation, bitter taste, burning pain in esophagus that is better when sitting up and worse when sitting down, chronic cough
GERD treatment
Antacids, H2 receptor antagonists, PPIs, prokinetic agents
Surgical intervention for GERD
Nissen fundoplication — invasive, fundus wrapped around esophagus
GERD patient education
Avoid fatty, fried, and spicy foods, citrus fruits, caffeine; eat 5 smaller meals as opposed to 3 large meals, remain upright after meals, avoid eating before bedtime, avoid tight clothing, lose weight, smoking cessation, reduce alcohol intake, elevate HOB at home
Protrusion of the stomach through the diaphragm into the thoracic cavity
Hiatal hernia
S/S of hiatal hernia
Heartburn, Dysphagia, chest pain after meals
Hiatal hernia treatment and education
Same as GERD
Inflammation of the gastric mucosa
Gastritis
Gastritis risk factors
H Pylori, long-term NSAID use, smoking, stress, heavy alcohol use
S/S of gastritis
Dyspepsia, N/V, stomach pain, bloating, lack of appetite, formation of ulcers when can bleed and cause anemia in severe cases
Erosion of the mucosa of the stomach, esophagus, or the duodenum
Peptic ulcer disease (PUD)
Key risk factor for PUD
H pylori infection; Other: chronic NSAIDs use, corticosteroid use
S/S of PUD
Epigastric pain (upper abdominal pain), N/V, bloating, hematemesis (coffee-ground), melena (bloody stool), pain differs based on type of PUD
Pain related to gastric ulcer
Pain 15-30 min after consuming meal, worse during day, worse with eating
Pain related to duodenal ulcer
Pain 2-3 hours after meal, pain worse at night, may be a little better with eating
PUD patient education
Avoid NSAIDs, caffeine, smoking, and alcohol
Complications of PUD
- Hypovolemic shock (d/t bleeding ulcers) — hypotension, tachycardia, tachypnea, low UOP; treat with administration of blood products and IV fluids
- Perforation (ulcer erodes through entire mucosa causing contamination of peritoneal cavity with gastric contents) — severe pain, fever, rigid board-like abdomen (peritonitis); treat this with emergency surgery (peritoneal lavage)
Foods that can trigger IBS symptoms
Milk, alcohol, caffeine, wheat, eggs
Key medications used in the treatment of IBS
Alosetron — IBS w/ diarrhea
Lubiprostone — IBS w/ constipation
IBS patient education
Keep symptom/food journal, increase fiber intake, increase physical activity, avoid gluten, reduce stress
Abdominal hernia risk factors
Obesity, pregnancy, lifting of heavy objects
Abdominal hernia S/S
Lump or protrusion at the affected site, severe pain and decreased bowel sounds (w/ strangulation and obstruction)
Abdominal hernia treatment
Truss (belt holds protruding tissue in place), surgical repair, bowel resection (if resulted in strangulation)
Patient education following hernia repair
Avoid coughing, if they need to cough or sneeze splint the area, avoid heavy lifting and straining
Risk factors for paralytic ileus
Abdominal surgery, electrolyte imbalances, abdominal infections, decreased blood supply to intestines
S/S of intestinal obstruction
Abdominal distention and pain, constipation, N/V, absent bowel sounds distal to obstruction
