Module 13

Question 1

Describe the anatomy of the gastrointestinal system and physiology of food intake

Answer 1

Digestion consists of mechanical breakdown that results from chewing, churning and mixing with fluid, as well as chemical reactions by which food is reduced to its simplest form. Digestion begins in the mouth where chewing mechanically breaks down food . The food then mixes with saliva which moistens and lubricates it, and has enzymes that digest carbohydrates. Then moves to the esophagus where muscular contraction brings it further down. Then goes to the stomach where it’s broken down, entering the duodenum where it is further broken down by acid and enzymes. Nutrients are absorbed in the small intestine, and the intestine’s villi increase the surface area of absorption. Nutrients are absorbed by passive diffusion, osmosis, active transport and pinocytosis. The main source of water absorption is the intestine. They also absorbed electrolytes and minerals. Glycogen synthesized from glucose and stored in small reserves in liver and muscle tissue provides energy during brief periods of fasting and maintains blood glucose levels as we sleep.

Question 2

Describe the nutritional components of food

Answer 2

• carbohydrates (saccharides, simple or complex, insoluble or soluble, glycemic index)
• proteins (essential and nonessential amino acids, complementary proteins, nitrogen balance)
• lipids (triglycerides, fatty acids, polyunsaturated fatty acids, trans fatty acids, cholesterol)
• water (cells depend on a fluid environment, body temp, solvent)
• minerals (catalysts for biochemical reactions, macro minerals, micro minerals)
• vitamins (essential to metabolism, antioxidant, fat soluble, water soluble)

Question 3

Discuss factors that influence food and fluid preference intake

Answer 3

• biological determinants: hunger, appetite, and taste
• economic determinants: cost, income, availability
• physical determinants: access, education, skills (e.g cooking) and time
• social determinants: culture, family, peers, and meal patterns
• psychological: mood, stress, guilt
• attitudes, beliefs, and knowledge about food

Question 4

Describe the components of a comprehensive abdominal subjective assessment

Answer 4

• common concerns and injuries: have you have any issues or concerns with indigestion, anorexia, nausea, vomiting, dysphasia, constipation, change in bowel functionality ? Use COLDSPAA to identify symptoms
• past history (family or personal) any recent weight changes, fatigue, food allergies, changes in appetite, smell, taste? Medical conditions related to digestion, chrones disease, celiac, metabolic syndrome, diabetes, GI disorders
• lifestyle: ask about what they had in the past three days, ask if they smoke, do they have any allergies, any cultural food restrictions ? Some DOH ( income, social support, physical environments)
• age related changes: slowed food digestive mechanisms when you’re older compared to younger adults

Question 5

Describe the components of a comprehensive abdominal objective assessment

Answer 5

Inspection (contour, symmetry, colour, moving, pulsation, scars, lesion, herniation and umbilicus)

Auscultation (auscultate all four quadrants, two to three times per quadrant, normal bowel sounds occur every 5-15 seconds) start in right lower quadrant, then right upper, then left upper, then left lower. Note the character of the sounds, rumbly or quiet?

Percussion (percussion in all four quadrants, same order, sound should be tympani high pitch and drum like, sound could be dull because it could be an organ that you’re tapping against)

Palpitation( one to two cm deep, all four quad, ask questions to know if they’re uncomfortable)

Question 6

assessing nutrition

Answer 6

• Food allergies
• Religious food restrictions
• Food likes & dislikes
• Preparing environment
• Presenting food
• Assisting with eating
• Monitoring intake

Question 7

Recommended Fluid Intake
 per Day

Answer 7

-Oral 1100 ml – 1400 ml
Water & other fluids

-800ml - 1000 ml
Food

-300ml
Metabolism

Total is 2200 – 2700 ml per day

Question 8

What is considered liquid?

Answer 8

Pudding, water, jello, ice

Question 9

What is considered low residue/pureed

Answer 9

mash potatoes, low fibre, pasta, finely diced meat

Question 10

If a patient has fluid or food restrictions of 1000ml per day for example, how would you break it up?

Answer 10

Plan your patient’s fluid or food distribution

Question 11

How can you prevent your patient from aspiration?

Answer 11

• High Fowler’s
• Chin tilted forward/down
• Thickened liquids
• Small bites
• Place food on “strong side”
• Turn head toward weaker side
• Double swallow
• Don’t rush
• Oral care after meal