Ch. 34: Assessement of Digestive and Gastrointestinal Function

Obstruction of the gastrointestinal tract leads to:

-increased force of intestinal contraction -distention above the point of obstruction -pain and a sense of bloating

The stomach, which derives its acidity from hydrochloric acid, has a pH of approximately:

1.0

The results of a gastric analysis can be used to diagnose various disease states. An excess amount of acid can indicate the presence of

a duodenal ulcer

pepsin

a gastric enzyme that is important in protein digestion

intrinsic factor

a gastric secretion that combines with vitamin B12 so that the vitamin can be absorbed

Fiberoptic colonoscopy

a. Liquids 24 to 72 hours before the exam b. Laxative 48 hours before procedure c. Laxatives until clear that AM of test, usually a polyethylene glycol electrolyte lavage solution (GoLYTELY) d. Clear liquids starting at noon on the day before test...

Barium enema

a. Low-residue diet 1 to 2 days before test b. Clear liquids the evening before c. A laxative the evening before d. NPO after midnight e. Cleansing enemas until returns are clear in the AM...

Upper gastrointestinal fiberscopic examination

a. NPO 6 to 12 hours before the procedure b. Spraying or gargling with a local anesthetic c. Administering intravenous versed before the scope is introduced

Gastric analysis

a. NPO 8 to 12 hours before the procedure... b. No medications affecting gastric secretions 24 to 48 hours before test c.No smoking in AM before test

achalasia

absence of peristalsis of the lower esophagus resulting in difficulty swallowing, regrgitation, and sometimes pain

hydrochloric acid

acid secreted by the glands in the stmach; mixes with chyme to break it down into absorbable molecules and to aid in the destruction of bacteria

lipase

an enzyme that aids in the digestion of fats

amylase

an enzyme that aids in the digestion of starch

An enzyme, secreted by the gallbladder, that is responsible for fat emulsification is:

bile

A fiberoptic colonoscopy is most frequently used for a diagnosis of:

cancer

Reflux of food into the esophagus from the stomach is prevented by contraction of the:

cardiac sphincter

Patient preparation for esophageal manometry requires the withholding of specific medications such as:

-anticholinergics -calcium-channel blockers -sedatives

Pancreatic secretions into the duodenum:

-are stimulated by hormones released in the presence of chyme as it passes through the duodenum -have an alkaline effect on intestinal contents -increase the pH of the food contents

Before a gastroscopy, the nurse should inform the patient that:

-he or she must fast for 6 to 12 hrs before the exam -his or her throat will be sprayed with a local anesthetic -after gastroscopy, he or she cannot eat or drink until the gag reflex returns (1 to 2 hours)

When completing a nutritional assessment of a patient who is admitted for a gastrointestinal disorder, the nurse notes a recent history of dietary intake. This is based on the knowledge that a portion of digested waste products can remain in the rectum for how many days after a meal is digested?

3 days

How many hours does it take after eating for food to pass into the terminal ileum?

4 hours

It usually take how long for food to enter the colon?

4 to 5 hours after a meal is eaten

Sucrase

Digests carbohydrates and helps form fructose

Pepsin

Digests protein and helps form polypeptides

Amylase

Facilitates the production of dextrins and maltose

Maltase

Glucose is a product of this enzyme's action

Trypsin

Helps convert protein into amino acids

Lactase

Helps form galactose

List three structural changes in the esophagus that occur as the result of aging:

decreased motility and emptying, weakened gag reflex, and decreased resting pressure of lower sphincter...

Abdominal pain associated with indigestion is usually:

described as crampy or burning

stomach

distensible pouch into which the food bolus passes to be digested by gastric enzymes

During a nursing assessment, the nurse knows that the most common symptom of patients with gastrointestinal dysfunction is:

dyspepsia

trypsin

enzyme that aids in the digestion of protein

A nurse who is investigating a patient's statement about duodenal pain should assess the:

epigastric area and consider possible radiation of pain to the right subscapular region

For adults who are older than 50 years of age and at low risk for colorectal cancer, the recommended screening is a:

fecal occult blood test annually

The major carbohydrate that tissues use for fuel is

glucose

The nurse auscultates the abdomen to assess bowel sounds. She documents five to six sounds heard in less than 30 seconds. She documents that the patient's bowel sounds are:

hyperactive

Consequences of diarrhea include all of the following EXCEPT:

hyperkalemia *consequences include: acidosis, decreased bicarbonate, electrolyte imbalance

Chyme, partially digested food that is mixed with gastric contents, stimulates segmented contractions, which are ________ and intestinal peristalsis, which is ____________.

mixed waves that move the intestinal contents back and forth in a churning motion; a movement that propels the contents of the small intestine toward the colon...

During the initial assessment of a patient complaining of increased stomach acid related to stress, the nurse knows that the physician will want to consider the influence of the neuroregulator:

norepinephrine

elimination

phase of digestive process that occurs after digestion and absorption, when waste products are evacuate from the body

digestion

phase of the digestive process that occurs when digestive enzymes and secretions mix with ingested food and when proteins, fats, and sugars are broken down into their component smaller molecules

ingestion

phase of the digestive process that occurs when food is taken into the GI tract via the mouth and esophagus

Magnetic resonance imaging (MRI) is contraindicated for patients who have:

-permanent pacemakers -artificial heart valves -implanted insulin pumps

How many hours doe it take for food to reach and distend the rectum?

12 hours...

A flexible sigmoidoscope permits examination of the lower bowel for:

16 to 20 in.

A gastric analysis with stimulation that results in an excess of gastric acid being secreted could be diagnostic of:

a duodenal ulcer

esophagus

collapsible tube connecting the mouth to the stmach, through which food passes as it it ingested

Bile, which emulsifies fat, enters the duodenum through the:

common bile duct

dyspepsia

indigestion, upper abdominal discomfort associated with eating

fibroscopy (gastrointestinal)

intubation of a part of the GI system with a flexible, lighted tube to assist in diagnossi and treatment of diseases of that area

anus

last section of the GI tract; outlet for waste products from the system

small intestine

longest portion of the GI tract, consisting of three parts - duodenum, jejunum, and ileum - through which food mixed with all secretions and enzymes passes as it continues to be digested and begins to be absorbed into the bloodstream

The digestion of starches begins in the mouth with the secretion of the enzyme:

ptyalin

absorption

phase of the digestive process that occurs when small molecules, vitamins, and minerals pass through the walls of the small and large intestine and into the bloodstream

A hormonal regulatory substance that inhibits stomach contraction and gastric secretions is:

secretin

Secretin is a gastrointestinal hormone that:

stimulates the production of bicarbonate in pancreatic juice

The nurse has been directed to position a patient for an examination of the abdomen. She knows to place the patient in the:

supine position with the knees flexed to relax the abdominal muscles

On examination of a patient's stool, the nurse suspects the presence of an upper gastrointestinal bleed when she observes a stool that is:

tarry and black

large intestine

the portion of the GI tract into which waste material from the small intestine passes as absorptin continues and elimination begins; consists of several parts- ascending segment, transverse segment, descending segment, sigmoid colon, and rectum

Name three pancreatic secretions that contain digestive enzymes:

typsin, amylase, and lipase...

Intrinsic factor is a gastric secretion neccessary for the intestinal absorption of the vitamin that prevents pernicious anemia, that is:

vitamin B12