digestive system. structure abdominal quadrants
TRANSCRIPT
Mouth
• where the digestive process begins
• consists of the tongue, salivary glands, teeth, and pharynx
Stomach
• a hollow, muscular, J-shaped organ• holds food from 3 to 4 hours• has three parts: the fundus, body, and
pylorus• produces gastric juices that help break
down food
Intestines
• the small intestine: where most of the food the body needs are absorbed into the bloodstream
• the large intestine: where most water is absorbed, wastes are changed into solid form
Liver
• The largest gland in the body
• helps control the amount of protein and sugar in the body by changing and storing excess amounts
Gallbladder
• a small hollow sac that is attached to the underside of the liver
• it releases bile from the liver into the small intestine to help digest a fatty meal
Malignancies• very common
• symptoms depend on location– indigestion–vomiting–constipation–obstruction–bloody stool
Gallbladder Conditions
• cholecystitis: inflammation of the gallbladder
• cholelithiasis: formation of stones in the gallbladder
Common Problems Related to the Lower Bowel
• diarrhea: multiple watery stools
• constipation: when stool passes through the colon too slowly – most severe form: fecal impaction
• bowel incontinence: involuntary passage of fecal material from the anus
NG Tube cont.
• may be placed for stomach decompression (ex. – during CPR)
• to give stomach rest
• to relieve nausea
CT Scans
• CTs may be done of abd/pelvis, with or without contrast (IV or PO)
• used to diagnose abnormalities/conditions of digestive system
Esophagogastroduodenoscopy (EGD)
• May be used to diagnose problems of the esophagus, stomach or duodenum
• May be done in GI Lab at a Hospital as an outpatient
Nutrition
• Food & fluids contain Nutrients-a substance the is taken in , digested, absorbed, and used by the body
• Grouped into fats, proteins, carbohydrates, vitamins, minerals, and water (FPCVMW)
• Which nutrients give the body fuel for energy?
• FPC• Energy measured in
calories• Food guide pyramid
helps to guide healthy food choices-has 4 levels
Nutrients
• Essential nutrients come from many different foods
• Refer to basic information sheet about nutrition
• Sometimes special diets needed to manage nutrition in patients
Fluid Balance
• Water needed to live• Death can occur if there
is too little or too much• Water is taken in
through food and fluids• Water lost through
elimination of urine and feces also through vomiting, perspiration and exhaling
• To be healthy fluid balance is needed
• Fluid taken in (intake) and lost (output) needs to be equal
• Swelling (edema) occurs when more is taken in than put out
• Dehydration occurs when more fluid is put out than taken in
Fluid Balance
• Adults need to take in 1500 ml per day
• For normal fluid balance about 2000-2500 ml is needed per day
• Normal person can take fluid orally
• Sometimes patients require special orders for fluids
• Fluids may need to be encouraged to increase intake
• Fluids may be restricted to a certain amount per day
Enteral Nutrition-Tubes• Nutrition given by gavage
(tube feeding)• Different types of tubes• Nasogastric (NG) -
inserted through the nose• Gastrostomy- inserted
into the stomach through a surgically created opening
• Jejunostomy – inserted in to small intestines through surgically created openint
• Percutaneous endoscopic gastroostomy (PEG) Tube- inserted into the stomach with an endoscope and through a puncture wound made through the skin into the stomach
Enteral Nutrition-Formula
• Formula ordered by doctor
• Most contain all of the nutrients
• Sometime may be made by the dietary department
• Feedings may be continuous or scheduled at intervals
• If they are continuous a pump is used to give the feeding
• Scheduled feedings may be given with a syringe or tube feeding bag that allows feeding to drip
Enteral Feeding- Observations
• Major risk is aspiration –which is breathing in of fluid or an object into the lungs
• Aspiration can cause pneumonia and death
• It is important to take measures to prevent aspiration
• Nurse must regularly make sure tube is in the right place because tubes can move from coughing and sneezing or vomiting
Tube Feeding-Preventing Aspiration
• X-ray may be taken after tube is inserted to verify placement
• Nurse may check tube placement by aspirating gastric secretions
• Prevent regurgetation by positioning patient in semi-Fowler’s Position –ask nurse of check care plan to find our how long
• If there is a delay in stomach emptying can regurgitate feeding
• Avoid left side lying position
• Less of a problem with J-Tube
Observations for Patients receiving Tube Feedings
• Observe and report immediately to nurse:
• Nausea, vomiting• Diarrhea• Discomfort during tube
feeding• Enlarged or swollen
stomach• Elevated temperature
• Redness, swelling, drainage
• odor or pain at the insertion site
• Difficulty breathing• Elevated pulse rate• Coughiing • Complaints of bloating
or flatulence
Intravenous Therapy
• This is giving fluids by way of a needle or catheter that has been inserted into a patient’s vein usually by an RN
• May be given in various settings such as hospital, outpatient, doctor’s office, home care setting, long-term care setting
• Requires a doctor’s order
• Given to replace fluids, replace vitamins and minerals lost from illness or injury
• Blood and blood products are given through IV
Intravenous Therapy Sites
• Peripheral Sites- away from the center of the body
• Sites may be in the hand, wrist, and antecubital space ( bend of elbow)
• If site is an IV catheter or needle facility may allow PCT to discontinue
• PCT must know how and have been delegated this responsibility by the RN before attempting to D/C an IV.
• Central Venous
TPN
• Provides total parenteral nutrition (TPN) also called Hyperalimentation to patients.
• May be given through aperipheral
• TPN contains all of the essential nutrients needed to sustain life, Fat may be added in the form of lipids
Specimen Collection Principles• Adhere to medical asepsis
principles• Follow Standard
Precautions• Use a clean or sterile
container for each specimen
• Use the right container for the specimen
Label the specimen correctly• Avoid touching the inside
of the container and lid• Urine must be free of
feces• No tissue in urine and
stool specimen• Place specimen in plastic
bag• Specimen should be taken
to lab promptly