GI Flashcards
What is propulsion along GI tract called
Peristalsis
Main function of GI tract
Supply nutrients to body cells
Taking food and moving it along the GI tract
Ingestion&Propulsion
Breakdown of food
Digestion
Transfer of food products into circulation
Absorption
Excreting the waste products of digestion
Elimination
How long is the GI tract? From where to where ?
30 feet
Mouth to anus
4 layers of entire GI tract
Mucous
Submucosa
Muscle
Serosa
What does Parasympathetic NS do when dealing with GI
Excitatory
What does sympathetic NS do when dealing with GI
Inhibitory
What in the GI tract sends signals to the ANS
Sensory fibers
Peristalsis in increased by _________ and decreased by __________ stimulation
Increased by parasympathetic and decreased by sympathetic
What is the enteric nervous system also known as
GUT BRAIN
Numerous neurons control movement and secretion of the GI tract
Enteric Nervous System (GI tract “nervous system”)
How much cardiac output does the GI tract receive
25-30%
The GI tract is a network of circulation connected to what 3 things
Vena cava
Spleen
Liver
A large amount if blood supply is diverted from the digestive system when?
During exercise/stress
What is mixing and propulsion called
Peristalsis
What does not have any enzymes or hormones in it
Esophagus
What are the 3 secretions of the GI tract
- enzymes and hormones for digestion
- mucus for protection and lubrication
- water and electrolytes
Peritonitis is an ___________
Emergency
Lines the abdominal cavity wall
Parietal
Covers the abdominal organs
Visceral
Space between the parietal and visceral layers
Peritoneal cavity
What is the peritoneum
2 layers that cover the abdominal organs
What blocks the trachea
Epiglottis
What is the job of the lower esophageal sphincter? Why does it need to close?
Wants food is in the stomach it closes. It has to close so you don’t get stuff from the stomach going back up. You don’t want any reflux of contents to leak back into the esophagus!
If something is wrong with the stomach what vitamin may you end up becoming deficient in?
B12
What gastric secretions and mixed with the food when it is stored in the stomach? Parietal cells: Chief cells: Pyloric gland: Intrinsic factor:
Parietal cells: HCl
Chief cells: pepsinogen
Pyloric gland: gastrin
Intrinsic factor: cobalamin (vit B12)
Once food becomes chyme what is it ready to do
Ready to enter the small intestine for further digestion and absorption
Once food is chyme what stimulates the motility and secretions
Pepsinogen
Lots of ______ secrete mucus and produce intestinal digestive enzymes
Villi
It is more ________ in the small intestines
Alkaline—less acidic
Once food arrives to the large intestines what are the 4 parts it has to go through
Cecum/appendix
Colon- ascending, transverse, descending
Rectum
Anus
Most important part of large intestinal function
Absorption of water and electrolytes
The large intestines secretes lots of _______ for ________ and ________ and stores _________.
Lg intestines secretes lots of mucus for lubrication and protection and stores feces
Is the movement in the large intestine fast or slow? What type of peristalsis occurs?
Movement is very slow, propulsive peristalsis occurs
What type of action is defecation?
Reflex action—> involuntary and voluntary control
What is the last thing kids develop
Sphincter control
When the anal sphincter senses pressure, what is defecation facilitated by??
Valsalva’s maneuver
What can dry mouth lead to
Decay of the teeth
Where is potassium secreted
Colon
Prolonged diarrhea can lead to what?
Hypokalemic states
About ____ to ____% of water in the GI tract that enters each day is absorbed in the small intestines
85-90%
Order of GI assessment
Inspection, Auscultation, percussion, palpation
What are some things that occur with chronic GI problems
Loss of energy, body is not functioning properly, slow to heal
GI pain is visceral pain and it is ______
Intense!
What is vomit looks like coffee grounds
Could be blood in the stomach
What happen if there is presence of fecal odor or bike in vomit
Could be obstruction
What should you do to prevent aspiration when somebody is vomiting
Turn person in their side
Who is at a threat for aspiration
Elderly, lethargic, sedated, unconscious patients
Where does the vomiting center in brainstem get impulses from
ANS
If somebody is vomiting what should you do until diagnosis is confirmed or further orders are written
Keep them NPO
What orders could you anticipate for a patient who is vomiting
- IV fluids for hydration and replacement of electrolytes
- NG tube for suction( for persistent vomiting or bowel obstruction)
What is biggest mistake people make when getting off NPO diet
Going to fast with diet
What should you do before giving somebody a antiemetic?
Determine the cause. Antiemetics can have undesirable effects for those with glaucoma, obstruction of pylorus, bladder neck, prostatic hyperplasia
What are preventive measures of constipation
High fiber, 3000 ml of fluid, regular elimination habits, exercise
What is somebody with anemia not getting enough of
Not getting enough intrinsic factor (vitamin B 12)
What happens with lactose intolerant
Lack of lactase enzyme. Diarrhea, loss of Ca++ and fluids and electrolytes
What happens with gluten intolerance
Atrophy of villi. Diarrhea of fatty stools (Celiac disease and nontropical spure) loss of vitamins A, D and iron, vitamin K, Ca++
Gluten free diet
Avoid wheat, barley, oat, rye. Use soybean flours, may have to use Corticosteriods for inflammatory process
Diarrhea is not a ______ it’s a _______
Not a disease, it is a SYMPTOM
Causes of diarrhea
- decreased fluid absorption (maldigestion/malabsorption)
- increased fluid secretion (infections, drugs, foods, hormones secreted d/t disease)
- motility disturbances (irritable bowel/diabetes/surgery)
How do antibiotics result in diarrhea
They kill the good and bad bacteria which causes diarrhea
What does diarrhea result in
Loss of fluids and electrolytes (K+ and Na+) , vitamins, and minerals —-> dehydration
What is the major cause of death in the world
Dehydration, lack or absorption of nutrients
Intestinal infections can be…?
Viral, bacterial, parasitic
Hallmark signs of blood in GI tract
Presence of blood, abdominal pain, decreased hemoglobin and hematocrit
What does bright red rectal bleeding mean
It is closer to the exit (lower GI)
What does tarry black stool mean
Higher up in GI tract. Color is caused by the loss of about 50-75 ml of blood from upper GI tract . Black color is from the iron in the RBC
Do you need a order for a Hemoccult test?
No!
What color will a Hemoccult (Guaiac) test turn if blood is present
Blue
Barium studies may be _______ or _________
Barium swallow or enema
What can barium cause
Constipation and obstruction. May have chalky stools for several days
When can somebody NOT get an MRI
When they have a metal plate in the, or they are pregnant
What does a CT scan do
Visualizes structures, organs, vessels, tumors
What is different about a MRI and a CT scan
MRI visualizes same as CT scan with more soft tissue detail
What is a nuclear imaging scan? When is it used? .
Injection of radioactive isotope into IV. It is used for lower GI bleeds, gastric reflux, diverticulum . You should schedule before any barium studies
What is a EGD
Esophagogastroduodenoscopy
Visualize the lining if the esophagus, stomach, and duodenum
NPO 8 hrs before
What is a colonoscopy
Scope inserted into anus to visualize rectum and large intestines
When is bowel cleansing prep started for somebody getting a colonoscopy
A bowel cleansing prep is started afternoon before test and the pt is started on a clear liquid diet (NO REDS)
When is first colonoscopy recommended? After that?
Age of 50. Then every 5-10 years after
What would you insert for gastric analysis
NG tube
Reflux of gastric contents into the lower esophagus causes irritation or inflammation
GERD
GERD medical management
Antacids, antisecretory agents (H2R blockers, PPIs), endoscopic procedures, surgery
Nursing management of GERD
- know your triggers! (High fat, alcohol, etc)
- elevate HOB 4-6 inches
- eat small, frequent meals with fluid between
- do not lie down within 2-3 hours of eating
Most common stomach problem
Gastritis
Breakdown of normal mucosa causing inflammation
Gastritis
Microorganisms that can cause gastritis
H.pylori
Salmonella
Staph
Drugs that can cause gastritis
NSAIDS
aspirin
Corticosteroids
What should you do with chronic gastritis
Focus on evaluating and eliminating the cause
Need to adapt lifestyle
Close medical follow up- May be a precursor to gastric cancer
Erosion of GI mucosa by HCI and pepsin
Peptic ulcer disease
Where may peptic ulcer disease occur
Lower esophagus,stomach, or duodenum
What is a insult to the body that may cause peptic ulcer disease
Burns!
What can relaxation techniques do for peptic ulcer disease management
Decrease acid secretion
How should somebody with peptic ulcer disease eat their meals
Regular 6 small meals/day of bland foods; no eating at bedtime
Most common complication of peptic ulcer disease
Hemorrhage - erosion of ulcer through a major blood vessel usually duodenal
Most life threatening complication to peptic ulcer disease
Perforation
Usually duodenal, erosion through serosal layer, spillage of contents into peritoneum , sudden pain , ridged board like abdomen
Treatment for acute exacerbations or complications of peptic ulcer disease
NPO NG tube to suction Bed rest IV fluid replacement/blood transfusions Surgery
