gastrointestinal system lecture 14. gi tract mouth pharynx esophagus stomach small intestine ...
TRANSCRIPT
Gastrointestinal System
Lecture 14
GI tract
• Mouth • Pharynx • Esophagus • Stomach • Small intestine • Large intestine
Esophagus
• Moves food via…• Peristalsis– “Alternating waves of
contraction and relaxation”
Stomach
• Mixes food with gastric juices – Chyme
• Pyloric sphincter– Controls stomach
emptying
• Stomach empties completely within 4-6 hours after a meal
Small intestine
• 3 areas– Duodenum
• Pancreas enzymes +• Bile
– Jejunum– Ileum
• Almost all food, water, vitamins and mineral are absorbed out of small intestines
Large Intestine
• AKA:– Colon
Accessory organs
• Liver• Gallbladder• Pancreas
Liver & Gallbladder
• Produces bile– Greenish– Emulsifies fats
• Extra bile is stored in the – Gallbladder
• Bile flows into– duodenum via – bile duct
Pancreas
• Secretes enzymes for food digestion
Nutrients
• “Substances in food that are used by the body for growth, maintenance and repair”– Carbohydrates– Protein– Fats– Vitamins– Minerals – Water
Metabolism
• Chemical reactions that happen in the cells in order to sustain life– Catabolism
• Breaking down structures for fuel
• “Burning”
– Anabolism• Combining simpler
molecules to build more complex structures
• “Building”
Carbohydrates
• Simple (sugar)– Sugar– Fruits
• Complex (Starch)– Grains– Legumes– vegetables
Carbohydrates
• Function– Convert to glucose – ATP – Fuel for the cells
Proteins
• Composed of amino acids• Complete proteins
– Milk– Meat– Fish– Poultry
• Plant proteins– Legumes– Nuts– Grains– Cereals
Protein
• Function– Vital for body structure
and function– Building and rebuilding
of tissue
Assessment
• Height & weight• Auscultate bowel
sounds– All 4 quadrants– Normal q 5-15 sec
• Palpate abdomen
Diagnostic Test
• Upper endoscopy• Exam esophagus,
stomach, duodenum and upper jejunum.
• Used to ID– Swallowing difficulty– Gastric reflux– Ulcers
Upper Endoscopy: Nrs Care
• Fasting 8 hours• Conscious sedation• Remove dentures• Hold food until gag &
cough reflex return• Warm saline gargles or
throat lozenges for comfort
Colonoscopy
• Visual examination of large intestine
• Used to – Screen for cancer– Remove polyps
Colonoscopy: Nrs Care
• Bowel prep• Conscious sedation
Terms: N/V
• Anorexia– Loss of appetite
• Nausea– Vague, unpleasant
sensation of sickness or queasiness
• Vomiting– Forceful expulsion of
stomach contents
N&V interventions
• Self limiting• Hold food initially • Clear liquids• Dry foods • Ginger
Inserting an NGT
• Standard precaution• Position– High Fowler’s
• Measure– Tip of nose– Earlobe– Distal sternum
Enteral Feeding
• HOB 30o
• Check tube placement– 30 mL air – Check residual
• Reinstill aspirated contents – > 100 mL GT– > 200 mL NGT
• Notify MD
Enteral feeding
• 30 mL water flush– a/– p/
Stomatitis
• Inflammation of the oral mucosa
Stomatitis: Nrs Care
• Oral care p/ eating• Avoid alcohol based
mouthwashes• High calorie & protein
diet• Soft, lukewarm or cool
foods• Small frequent meals• Avoid spicy foods
Gastroesophageal Reflux Disease
• Backwards movement of gastric content
• GERD• S&S– Heartburn– Sore throat– hoarsness
GERD: Nrs Care
• Avoid lying down (3 hr) p\ meals
• HOB up 6 inches• Avoid alcohol and
tobacco• Weight loss promotion• Avoid acidy foods• Administer meds– Histamin-2 receptor
blockers
Peptic Ulcer Disease (PUD)
• Break in the mucous lining of the stomach or duodenum where it comes in contact with gastric juice
PUD – S&S
• Pain– Burning, aching, unger-
like– Relieved by eating– Heartburn
• Elderly– No symptoms
PUD - complications
• Hemorrhage– Hematemesis– Orthostatic hypotension– Occult stool– Fatigue, weak
• Obstruction– Feel full– N&V
• Perforation– Severe pain– No BS