Gastrointestinal System Flashcards
1
Q
Upper right quadrant
A
Liver
Transverse colon
2
Q
Upper left quadrant
A
Stomach
3
Q
Lower right quadrant
A
Ascending colon
Small intestine
4
Q
Lower left quadrant
A
Sigmoid colon
Descending colon
Small intestine
5
Q
The large intestine absorbs
A
Water
Sodium
Chloride
6
Q
The large intestine secretes
A
Bicarbonate
Potassium
7
Q
Nutrients
A
Carbs Proteins Fats Water (60-70% weight) Vitamins and minerals
8
Q
The small intestine is lined with
A
Villi
9
Q
The small intestine absorbs
A
Carbs
Protein
Minerals
Water-soluble vitamins
10
Q
Methods of absorption
A
Passive diffusion
Osmosis
Active transport
Pinocytosis
11
Q
Catabolism occurs during
A
Physiological states of negative nitrogen balance
12
Q
Chyme moves through the _____ to the large intestine
A
Ileocecal valve
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
14
Q
Other factors affecting nutrition
A
Religion Culture Ethics Health benefits Preference Environmental
15
Q
Ovolactovegetarian
A
Avoids meat, fish, and poultry, but eats eggs and milk
16
Q
Lactovegetarian
A
Drinks milk but avoids eggs
17
Q
Vegan
A
Consumes only plant foods
18
Q
Zen macrobiotic
A
Rice, beans, sea vegetables
19
Q
Fruitarian
A
Fruit, nuts, honey, and olive oil
20
Q
Subjective measures of GI and nutrition health
A
Diet
Health history
21
Q
Objective measures of GI/nutrition health
A
Dysphagia BMI Ideal body weight (IBW) Serum analysis Stool specimen
22
Q
Serum analysis
A
Measures of overall nutritional status
Looks at protein and albumin
23
Q
Stool specimen
A
Hemoccult checks for blood
Culture looks at pathology
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
25
Hematemesis
Vomiting blood
26
Order of GI assessment
IAPP
27
Absent bowel sounds
Must be auscultated for 5 whole minutes
28
Hypoactive bowel sounds
<5/minute
29
Normoactive bowel sounds
5-35/minute
30
Hyperactive bowel sounds
>35/minute
31
Borborygmi
Continuous growling
32
Pleximeter
Middle finger on abdomen
33
Plexor
Finger tapping
34
Enteral feedings
Liquid feedings administered through tube to bypass pharynx and esophagus
35
Tube feeding order includes
Type of tube
Type and amount of feeding
Frequency of feeding
Flush (follow policy)
36
Nasogastric tube
8-12 French sizes
Placed by RN
Flexible with stylet for adults
37
Gastrostomy tube
G tube or PEG (percutaneous enterogastrostomy tube)
| Surgically placed in the stomach
38
Jejunostomy
J tube
| Surgically placed in jejunum
39
Mickey button
Pediatrics tube
40
NG tube placement
```
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
Methods for verification of NG tube placement
Aspirate gastric contents
Test pH
X-ray verification
42
Intermittent/bolus feedings are by default given every
4 hours
43
HOB angle for intermittent feeding
30 degrees
44
Intermittent tube feeding
```
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
Assess NG and G tube ever
4 hours
| Look at tube placement, function, surrounding skin
46
Tube function assessment
Check residual stomach contents every 4 hours for continuous feeds and prior to every intermittent feeding
If residual is high consult policy
47
Enteral feeding interventions for aspiration
Elevate HOB to 30º
Check tube placement
Promote gastric motility with activity
Check residual
48
Enteral feeing interventions for fluid/electrolyte imbalance
```
Return residual to stomach
Provide water
Assess bolus vs continuous
Consider concentration
I&O
Daily weight
```
49
Clogged tube intervention
Flush thoroughly and frequently
50
Skin breakdown intervention
Frequent assessment
Keep clean and dry
Reposition PRN
51
Bacterial growth NG tube intervention
Hang only 4 hours of feeding at a time
| Change bag and tubing every 24 hours
52
NG tube diarrhea intervention
Treat symptoms
| Ask for change in feeding concentration
53
NG tube irrigation
Inject 30 mL of water and immediately aspirate
54
Constipation
Infrequent stool or hard, dry, small stools that are difficult to eliminate
55
Diarrhea
An increase in the number of stools and the passage of liquid, unformed feces
56
Flatulence
Accumulation of gas in the intestines causing the walls to stretch
57
Impaction
Results from unrelieved constipation; a collection of hardened feces wedged in the rectum that a person cannot expel
58
Incontinence
Inability to control passage of feces and gas
59
Hemorrhoids
Dilated, engorged veins in the lining of the rectum
60
Factors affecting bowel elimination
```
Age
Fluid intake
Psychological
Position during defecation
Pregnancy
Medications
Diet
Physical activity
Personal habits
Pain
Surgery/anesthesia
Diagnostic tests
```
61
At-risk clients for bowel elimination
```
Immobile
Low fiber
Low fluid intake
Routine laxatives
Narcotics
Post abdominal surgery
Liquid diet, medications
```
62
Constipation prevention
```
Regular bowel habits
High fiber and fluids
Take time for defecation
Privacy
Respond to the urge
Sitting position
Ambulation
```
63
Gastrocolic reflex
Eating moves the GI tract
64
Constipation interventions
Increase fluids
Increase activity
Laxatives
Enemas
65
Hypotonic enema
Lower tonicity than interstitial fluid; fluid escapes from the bowel into interstitial spaces
Tap water, high volume
66
Hypotonic enema risks
Water toxicity
67
Isotonic enema
Same tonicity as interstitial fluid, no fluid shift
| Normal saline
68
Safest enema
Isotonic
69
Hypertonic enema
Higher tonicity than interstitial fluid' pulls fluid from interstitial spaces into colon
Fleets, low volume
70
Hypertonic enema risk
Dehydration
71
Soap suds enema
Irritates and causes defecation
72
Enema complications
```
Cramping
Rectal mucosa trauma
Perforation
Fluid/electrolyte imbalance
Vagal nerve stimulation
```
73
Intervention for vagal nerve stimulation during enema
Increase venous return
74
Types of bedpans
Regular
| Fractured
75
Bed angle for bedpan
30-45º
76
Bowel diversions
Temporary or permanent artificial opening in the abdominal wall
77
Ostomies
```
Sigmoid colostomy
Transverse colostomy
Ileostomy
Loop colostomy
End colostomy
```
78
Ostomy assessment
Stoma should be beefy red and moist
| Skin should be warm, dry, and intact, no erythema, no exudate
79
Interventions for anorexia
```
Environment to promote appetite
Oral care
Socialization
Small, frequent meals
Assist
Nutritional support
```
80
Interventions for dysphagia
```
HOB 90º
Thicken fluids
Feed slowly
Small, frequent meals
No talking
Do not socialize
```
