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Fundamentals > Gastrointestinal System > Flashcards

Gastrointestinal System Flashcards

1
Q

Upper right quadrant

A

Liver

Transverse colon

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2
Q

Upper left quadrant

A

Stomach

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3
Q

Lower right quadrant

A

Ascending colon

Small intestine

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4
Q

Lower left quadrant

A

Sigmoid colon
Descending colon
Small intestine

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5
Q

The large intestine absorbs

A

Water
Sodium
Chloride

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6
Q

The large intestine secretes

A

Bicarbonate

Potassium

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7
Q

Nutrients

A 
Carbs
Proteins
Fats
Water (60-70% weight)
Vitamins and minerals
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8
Q

The small intestine is lined with

A

Villi

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9
Q

The small intestine absorbs

A

Carbs
Protein
Minerals
Water-soluble vitamins

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10
Q

Methods of absorption

A

Passive diffusion
Osmosis
Active transport
Pinocytosis

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11
Q

Catabolism occurs during

A

Physiological states of negative nitrogen balance

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12
Q

Chyme moves through the _____ to the large intestine

A

Ileocecal valve

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13
Q

Lifespan factors affecting nutrition

A 
Lifespan
Infants: rapid growth
Adolescents: metabolic demands and muscle growth
Pregnancy/lactation: calories
Adults: maintain
Older adults: decreasing metabolic rate
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14
Q

Other factors affecting nutrition

A 
Religion
Culture
Ethics
Health benefits
Preference
Environmental
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15
Q

Ovolactovegetarian

A

Avoids meat, fish, and poultry, but eats eggs and milk

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16
Q

Lactovegetarian

A

Drinks milk but avoids eggs

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17
Q

Vegan

A

Consumes only plant foods

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18
Q

Zen macrobiotic

A

Rice, beans, sea vegetables

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19
Q

Fruitarian

A

Fruit, nuts, honey, and olive oil

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20
Q

Subjective measures of GI and nutrition health

A

Diet

Health history

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21
Q

Objective measures of GI/nutrition health

A 
Dysphagia
BMI
Ideal body weight (IBW)
Serum analysis
Stool specimen
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22
Q

Serum analysis

A

Measures of overall nutritional status

Looks at protein and albumin

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23
Q

Stool specimen

A

Hemoccult checks for blood

Culture looks at pathology

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24
Q

Nutritionally at-risk clients

A 
Immobile
Hypercatabolic states (fever, burns, sepsis)
GI/oral symptoms
Altered LOC
NPO for more than 5 days post op
Lifespan
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25
Q

Hematemesis

A

Vomiting blood

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26
Q

Order of GI assessment

A

IAPP

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27
Q

Absent bowel sounds

A

Must be auscultated for 5 whole minutes

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28
Q

Hypoactive bowel sounds

A

<5/minute

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29
Q

Normoactive bowel sounds

A

5-35/minute

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30
Q

Hyperactive bowel sounds

A

> 35/minute

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31
Q

Borborygmi

A

Continuous growling

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32
Q

Pleximeter

A

Middle finger on abdomen

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33
Q

Plexor

A

Finger tapping

34
Q

Enteral feedings

A

Liquid feedings administered through tube to bypass pharynx and esophagus

35
Q

Tube feeding order includes

A

Type of tube
Type and amount of feeding
Frequency of feeding
Flush (follow policy)

36
Q

Nasogastric tube

A

8-12 French sizes
Placed by RN
Flexible with stylet for adults

37
Q

Gastrostomy tube

A

G tube or PEG (percutaneous enterogastrostomy tube)

Surgically placed in the stomach

38
Q

Jejunostomy

A

J tube

Surgically placed in jejunum

39
Q

Mickey button

A

Pediatrics tube

40
Q

NG tube placement

A 
Assess nares, oral, abdomen
Measure nose to ear to xiphoid process
Mark length
Lubricate
Insert with head extended
Tip forward and swallow when tube reaches posterior pharynx
Anchor in two places
Veryify placement
41
Q

Methods for verification of NG tube placement

A

Aspirate gastric contents
Test pH
X-ray verification

42
Q

Intermittent/bolus feedings are by default given every

43
Q

HOB angle for intermittent feeding

A

30 degrees

44
Q

Intermittent tube feeding

A 
Aspirate and measure contents
Clamp tube, remove syringe
Attach new syringe, flush 30 mL of water
Feed
Flush with 30 mL
Clamp and cap
45
Q

Assess NG and G tube ever

A

4 hours

Look at tube placement, function, surrounding skin

46
Q

Tube function assessment

A

Check residual stomach contents every 4 hours for continuous feeds and prior to every intermittent feeding
If residual is high consult policy

47
Q

Enteral feeding interventions for aspiration

A

Elevate HOB to 30º
Check tube placement
Promote gastric motility with activity
Check residual

48
Q

Enteral feeing interventions for fluid/electrolyte imbalance

A 
Return residual to stomach
Provide water
Assess bolus vs continuous
Consider concentration
I&amp;O
Daily weight
49
Q

Clogged tube intervention

A

Flush thoroughly and frequently

50
Q

Skin breakdown intervention

A

Frequent assessment
Keep clean and dry
Reposition PRN

51
Q

Bacterial growth NG tube intervention

A

Hang only 4 hours of feeding at a time

Change bag and tubing every 24 hours

52
Q

NG tube diarrhea intervention

A

Treat symptoms

Ask for change in feeding concentration

53
Q

NG tube irrigation

A

Inject 30 mL of water and immediately aspirate

54
Q

Constipation

A

Infrequent stool or hard, dry, small stools that are difficult to eliminate

55
Q

Diarrhea

A

An increase in the number of stools and the passage of liquid, unformed feces

56
Q

Flatulence

A

Accumulation of gas in the intestines causing the walls to stretch

57
Q

Impaction

A

Results from unrelieved constipation; a collection of hardened feces wedged in the rectum that a person cannot expel

58
Q

Incontinence

A

Inability to control passage of feces and gas

59
Q

Hemorrhoids

A

Dilated, engorged veins in the lining of the rectum

60
Q

Factors affecting bowel elimination

A 
Age
Fluid intake
Psychological
Position during defecation
Pregnancy
Medications
Diet
Physical activity
Personal habits
Pain
Surgery/anesthesia
Diagnostic tests
61
Q

At-risk clients for bowel elimination

A 
Immobile
Low fiber
Low fluid intake
Routine laxatives
Narcotics
Post abdominal surgery
Liquid diet, medications
62
Q

Constipation prevention

A 
Regular bowel habits
High fiber and fluids
Take time for defecation
Privacy
Respond to the urge
Sitting position
Ambulation
63
Q

Gastrocolic reflex

A

Eating moves the GI tract

64
Q

Constipation interventions

A

Increase fluids
Increase activity
Laxatives
Enemas

65
Q

Hypotonic enema

A

Lower tonicity than interstitial fluid; fluid escapes from the bowel into interstitial spaces
Tap water, high volume

66
Q

Hypotonic enema risks

A

Water toxicity

67
Q

Isotonic enema

A

Same tonicity as interstitial fluid, no fluid shift

Normal saline

68
Q

Safest enema

69
Q

Hypertonic enema

A

Higher tonicity than interstitial fluid’ pulls fluid from interstitial spaces into colon
Fleets, low volume

70
Q

Hypertonic enema risk

A

Dehydration

71
Q

Soap suds enema

A

Irritates and causes defecation

72
Q

Enema complications

A 
Cramping
Rectal mucosa trauma
Perforation
Fluid/electrolyte imbalance
Vagal nerve stimulation
73
Q

Intervention for vagal nerve stimulation during enema

A

Increase venous return

74
Q

Types of bedpans

A

Regular

Fractured

75
Q

Bed angle for bedpan

76
Q

Bowel diversions

A

Temporary or permanent artificial opening in the abdominal wall

77
Q

Ostomies

A 
Sigmoid colostomy
Transverse colostomy
Ileostomy
Loop colostomy
End colostomy
78
Q

Ostomy assessment

A

Stoma should be beefy red and moist

Skin should be warm, dry, and intact, no erythema, no exudate

79
Q

Interventions for anorexia

A 
Environment to promote appetite
Oral care
Socialization
Small, frequent meals
Assist
Nutritional support
80
Q

Interventions for dysphagia

A 
HOB 90º
Thicken fluids
Feed slowly
Small, frequent meals
No talking
Do not socialize

Fundamentals (11 decks)

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