Unit 7 - A Flashcards by Shak Alawdi

What are the organs making up the GI tract?
When does digestion begin?

Mouth, esophagus, stomach, small & large intestine, rectum, anus. Liver, pancreas, gallbladder.
Digestion begins before food enters the mouth.

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Define the terms ingestion & digestion/absorption

Ingestion: Intake of food.
Digestion & Absorption: Happens in the stomach and small intestine.

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What is the function of the pancreas?

Neutralizes acidity of chyme.
Aids in digestion of fats/carbohydrates/proteins.

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What is the function of the liver?

Makes bile.
Helps convert ammonia to urea.

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What is the function of bile and where is it made/stored?

Bile aids in breakdown of fats.
Made in liver, stored in gallbladder.

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What is the function of the small intestine and villi?

Uptake of nutrients to the bloodstream.

Villi:
Increase surface area for absorption.

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What is the function of the large intestine?

Absorption of water & electrolytes.
Formation & expulsion of feces.
Secretes mucus for lubrication & protection of mucosal lining.
Synthesize vitamin K & some B vitamins.
Final breakdown of undigested proteins.

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What controls peristalsis?

Under control of nervous system:
Parasympathetic - stimulates
Sympathetic - inhibits

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What is the general make-up of feces?

75% water
Bacteria
Unabsorbed minerals
Undigested foodstuffs
Bile pigments
Epithelial cells

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How would you assess the GI tract?

Inspection, auscultation, palpation.
Observe contour/masses/scars/distention.
Listen for 30s-5min in all quadrants.
Listen for bowel sounds - absent, hypo-, normo-, hyper-
Identify flatus.

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How would you examine the anus/rectum?

Inspect for lesions, ulcers, fissures, inflammation/external hemorrhoids.
Inspect for skin irritation.

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How would you assess the pt. elimination patterns? (UARPB)

Ask: UARPB
Usual pattern
Aids
Recent changes
Problems
Bowel diversion

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What affects bowel elimination?

DALMS

Daily patterns
Amount of food & fluid
Level of activity
Medication
Surgery

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What are the effects of aging on the GI system?

Xerostomia (Dry mouth)
Decreased appetite
Delayed emptying of esophagus
Decreased HCI secretion

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What diagnostic studies can be performed on the GI system?

-Stool collection/culture
-Direct Visualization:
* EGD
*Colonoscopy
*ERCP
-Indirect Visualization:
*UGI
*Barium Edema
*MRI/CT Scan

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What does a liver biopsy do and what liver function lab tests can you do? What are the normal values of the lab tests?

-Direct pressure against liver.
-Liver enzymes: ALP (30-120U/L) / ALT (12-78U/L) / AST (0-37U/L)
-Proteins: T. Protein(6.4-8.2g/dL), Albumin(3.2-4.7g/dL), Globulin(2.3-3.5g.dL).
-Bilirubin: Total (<1.1mg/dL). Direct (0-0.30mg/dL).

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Define nausea and anorexia.

-Feeling of discomfort/desire to vomit.
-Fear of gaining weight.

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Define vomiting.

Forceful ejection of ingested food & secretions.

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What can you do to prevent nausea & vomiting?

-Give IV fluid/ electrolytes and glucose.
-Use NG tube.
-Use advance DAT.

What is a nasogastric (NG) tube and what does it do?

-Allows the GI tract to rest before/after surgery.
-It’s inserted to monitor for GI bleeding.
-Must clamp when giving medications.
-You must verify placement.

Define the terms aspiration & dysphagia. What do you give a pt. with dysphagia?

-Inhalation of foreign material.
- Difficulty swallowing: Give thickened liquids.

What must you do when giving enteral nutrition (tube feedings)?

-You must perform an X RAY.
-Place HOB over 30º to avoid aspiration.

What is diarrhea? What is it caused by?
Define acute vs chronic diarrhea.

Anything more than 3 stools/day.
Acute: Less than 14 days.
Chronic: More than 30 days.
Caused by bacteria.

What are some nonpharmacologic interventions for diarrhea?

Give clear liquids.
-Give oral solutions such as gatorade & pedialyte.
Give IV electrolytes.

What are the nursing interventions for pt. with diarrhea?

-Answer call lights. -Remove cause of diarrhea. -Monitor region around the anus.

What is C. Difficile? What are its risk factors?

-Watery diarrhea, fever, anorexia, nausea, and abd pain. - It is a hospital acquired infection. -Risk factors: * Abx, chemo, and immunosuppressive drugs.

Antidiarrheals: Diphenoxylate & Loperamide; what do they do?

-Decrease hypermotility -Can cause CNS/respiratory depression, & physical dependance.

Adsorbents: Bismuth subsalicylate What do they do? What are their side effects?

-Coat GI tract wall. -Absorb bacteria/toxins causing diarrhea. - S/E: Dizziness/drowsiness, abd pain, constipation.

What are the characteristics of constipation?

-Less than 4 stools/week. -Straining -Hard, dry, difficult to pass stools. -Incomplete evacuation

What are the risk factors for constipation? LDEC

-Low fiber/fluid intake -Decreased physical activity -Emotions/pain -Constipating medications

What foods have a laxative effect?

Fruits, vegetables, bran, chocolate, alcohol, coffee.

What foods have a gass-producing effect?

Onions, cabbage, beans, cauliflower.

What foods increase the chance for constipation to occur?

Cheese, lean meat, eggs, pasta.

What are some nonpharmacologic measures to prevent constipation?

-High fiber diet -Increased water intake -Position knees above hips -Exercise

What are some pharmacologic measures to prevent constipation? Any side effects?

Give Laxatives such as: -Osmotic (saline) -Stimulant (irritants) -Bulk-forming -Emollient (stool softeners) S/E: N.V.D./cramping, flatulence Give Enemas

What are some laxative contraindications?

-Undiagnosed abd pain -Inflammatory GI disorders -Bowel obstruction -Spastic bowel (IBS) -Pregnancy

What types of enemas can you give?

-Cleansing -Retention -Large volume -Small volume

What do bulk-forming laxatives do?

-Absorb water into the intestine and increase fecal bulk. -Results usually occur 8-24hrs -Insufficient water intake can cause drug to solidify and cause an obstruction

What do emollients (stool softeners) do?

-Lowers surface tension inside intestines -Promotes water accumulation in intestine and stool -Prevents constipation -Decreases straining

What do stimulant laxatives do?

-Increases peristalsis by irritating sensory nerve endings in intestinal mucosa -Produces watery stools -PO: within 6-8 hrs. PR: 15-60 mins. -Used to empty bowel prior to diagnostic study

What do osmotic laxatives include and do?

Include: -Salts/saline products -Lactulose -Glycerin -Pulls water into colon and feces, increasing bulk and peristalsis -Monitor electrolytes to avoid imbalance

What can cause fecal incontinence?

-Constipation/fecal impaction -Trauma -Caffeine/dairy products/insoluble fiber veggies

What types of ostomies can you put?

-Sigmoid -Descending -Transverse -Ascending -Ileostomy

What is the stool consistency from ostomies?

-Ileostomy allows liquid fecal content -Colostomy allows formed feces content

What are the types of ostomy appearances?

-Normal: Dark pink/red, moist, rounded. -Pale: Indicates severe anemia. -Eroded: May lead to a flush stoma.

What are esophageal & gastric varices? Any risks? Medications?

-Similar to hemorrhoids but in the esophagus and stomach. -High risk for internal bleeding when inserting NG tubes. -Medications: Somatostatin analog.