GI assessment Flashcards
whats the primary function of the GI system
- breakdown of food for digestion
- absorption of nutrients into the bloodstream
- elimination of undigested food and waste products
whats included in the GI system
its a closed system
mouth -> esophagus -> stomach -> small intestine and large intestine -> rectum -> anus
includes accessory organs like liver, gallbladder, and pancreas
wheres a lot of stuff absorbed
small intestine
whats included in the portal venous system
- superior mesenteric
- inferior mesenteric
- gastric
- splenic
- cystic
is the GI system innervated by SNS and PNS?
yes
does aging have a minimal effect or crazy big effect on GI function
minimal
what happens to the GI system as we age
- dysphagia, anorexia, dyspepsia, disorders of colonic function
- difficulty chewing and swallowing
- reflux and heart burn
- decreased motility and transit time (indigestion and constipation)
- decreased absorption of nutrients (dextrose, fats, calcium, iron)
- fecal incontinence (duller nerve impulses in rectal area)
describe stool studies
- guiac/hemoccult (find blood in shit)
- fecal DNA
- ova and parasites
- cdiff
describe serum labs for GI system
- CBC, CMP/BMP
- triglcerides
- LFTs
- amylase/lipase
- CEA/CA/alpha-fetoprotein
describe abdominal US
- noninvasive, little prep, no side effects
- gallbladder, pancreas, and appendix
- fat free meal day before, NPO night prior to surgery
describe fluoroscopy with X-ray
- moving picture
- use barium (contrast) aka barium swallow
- usedful to detect foreign bodies, ulcers, and varices and GI motility
- NPO previous night @ midnight
- patient will drive home after
- ancourage fluids to flush out barium
- may have white stools and GI uspet
describe upper GI fibroscopy/EGD
- direct visualization of esophogeal, gastric, and duodenal mucosa
- NPO previous night @ midnight
- conscious sedation; anesthetic to back of throat (informed consent)
- patient will be sent to PACU and can not drive post procedure
- may have sore throat; discuss use of throat lozenges and soft foods
- assess for return of gag reflex prior to allowing food and fluids
- patient may feel bloated due to air injection during study
describe lower GI fluoroscopy
- fluouroscopy and xray with barium enema
- examination of colon, look for constipation and GI conditions
describe CT
- with or without contrast
- allergies to shellfish/iodine?
- NO metformin 48hrs before or after
describe colonoscopy
- visual exam of anus, rectum and colon
- used to detct and remove polyps (precancer)
- to diagnose or rule out disorders of the colon
- conscious sedation; patient will need ride home after exam
- informed consent
- patient on left side during exam
- NPO midnight prior to exam
- bowel prep to remove all contents from GI
- instill air to open colon; patient may feel bloated and pass gas after exam
describe NG tube
- used for feedings/med admin
- decompress stomach
- remove content from stomach
describe OG tube
- intubated patient
- short term, less commonly used
describe gastrostomy
- opening in stomach
- admin of foods, fluids, and meds
- gastric decompression
- best for enteral support needed for longer than 4 weeks
- G tubes (via stomach)
- PEG tubes (longer than G tube)
describe jejunostomy
- opening into jejeunum
- admin of food, fluids, and meds
- used when gastric route no accessible or contraindicated
what are some nursing considerations for GI tubes
- check residual volume
- supposed to do one med at a time
- fowlers position for feeding
- oral care is important
- dressing changes
describe TPN
- method of providing nutrients to the body by an IV route
- contains proteins, carbs, fats, electrolytes, vitamins, trace minerals, and sterile water
- 1-3L over 24hr period
- IVFEs (fat) may be infused simultaneously (1-3x/wk)
what line is used for TPN
PICC or central line ONLY
what line is used for PPN
peripheral line
what should you watch for with TPN
rebound hypoglycemia
TPN is equilant to 3 cans of coke daily and pt may need insulin with TPN
what are some signs of hypoglycemia
- sweating
- trembling
- dizziness
- mood changes
- hunger
- headaches
- blurred vision
- extreme tiredness and paleness
what are some signs of hyperglycemia
- dry mouth
- extreme thirst
- pissing machine
- drowsiness
- bed wetting
- stomach pain
