Ch. 38 GI system
The nurse determines that a patient has an increased risk of constipation. Which statement made by the patient supports the nurse's conclusion? Select all that apply. "I take aspirin regularly." "I am exercising regularly." "I haven't been drinking much." "I'm not eating much dietary fiber." "I defecate as soon as I feel the urge."
"I haven't been drinking much." "I'm not eating much dietary fiber." The patient with constipation should increase fluid intake because fluid consumption makes stools softer and prevents constipation. The patient should increase the intake of dietary fiber because it adds bulk to fecal material and ensures easy passage of stool through the gut and prevents constipation. Aspirin is an analgesic and does not increase the risk of constipation. Exercise enhances the gastrointestinal motility and reduces the risk of constipation. Avoiding suppressing defecation over long periods will prevent constipation.
The nurse describes the digestive process to a patient who is scheduled for gallbladder surgery. The nurse should explain that which enzyme affects the absorption of fat-soluble vitamins? Bile Lipase Sucrase Amylase
Bile Bile emulsifies fats and aids in the absorption of fatty acids and fat-soluble vitamins. Amylase aids in carbohydrate digestion. Lipase aids in fat digestion. Sucrase converts glucose to galactose.
The nurse educator provides education to a group of nursing students about age-related changes in the gastrointestinal system. Which statement by a student indicates the need for further teaching? "Increased transit time occurs with aging." "Increased salivary volume occurs with aging." "Decreased protein synthesis occurs with aging." "Decreased blood flow to the stomach occurs with aging."
"Increased salivary volume occurs with aging." The volume of saliva decreases rather than increases with aging. Increased transit time, decreased protein synthesis, and decreased blood flow to the stomach are expected age-related changes to the gastrointestinal system.
The nurse is reviewing information about the gastrointestinal system with a nursing student. Which statement made by a student indicates the need for further teaching? "Sympathetic innervation is an adrenergic system that increases peristalsis." "Parasympathetic innervation is a cholinergic system that increases peristalsis." "The gastrointestinal tract has an enteric nervous system that regulates mobility." "The enteric gastrointestinal nervous system operates independently of the brain."
"Sympathetic innervation is an adrenergic system that increases peristalsis." Parasympathetic innervation is a cholinergic, not an adrenergic, system that increases peristalsis. The gastrointestinal tract has an enteric nervous system to regulate mobility. Sympathetic innervation is an adrenergic system that increases peristalsis. The enteric gastrointestinal nervous system operates independently of the brain and spinal cord.
A patient reports a history of chronic high-dose acetaminophen use. It is important for the nurse to monitor the patient for what? Diarrhea Xerostomia Hypochlorhydria Abnormal liver function tests
Abnormal liver function tests Chronic high doses of acetaminophen and NSAIDs may be hepatotoxic. Liver function tests should be monitored closely. Hypochlorhydria (decreased hydrochloric acid secretion), xerostomia (very dry mouth), and diarrhea are not side effects of acetaminophen.
The nurse recalls that which term is used to describe the process of transferring broken down food components from the gastrointestinal system to the blood? Ingestion Digestion Absorption Elimination
Absorption is the process in which the nutrients from the broken down food are assimilated by the blood and transferred into the circulatory system. Ingestion refers to the process of taking in of food. Digestion refers to the process of breaking down the food into simpler particles. Elimination is the process of removal of waste products of digestion from the body.
A patient experiences a recent onset of diarrhea following a new medication regimen. The nurse reviews the patients medication profile and suspects that which medication is the cause of the diarrhea? Antacid Antibiotic Amphetamine Nonsteroidal antiinflammatory drug (NSAID)
Antibiotic Antibiotics disturb the normal bacterial composition of the large intestine and result in diarrhea. Diarrhea is not a known side effect of NSAIDs, amphetamines, and antacids. High doses of NSAIDs can cause hepatotoxicity. Amphetamines cause distention of the stomach. Antacids cause interference with the absorption of other drugs. p. 840
What is the function of the hormone ghrelin? Fat digestion Appetite stimulation Breakdown of proteins Breakdown of starches to maltose
Appetite stimulation Ghrelin is released from the stomach mucosa; it stimulates appetite. Lipase causes fat digestion. Pepsin breaks down proteins. Ptyalin breaks down starches to maltose. p. 834
The nurse finds that an older adult patient is showing signs of anemia. What age-related change is the reason for this condition? Atrophy of gastric mucosa Reduced protein synthesis Decreased HCl acid secretion Destruction of α cells of islets of Langerhans
Atrophy of gastric mucosa The aging process causes atrophy of the gastric mucosa and decreases blood flow to the stomach. It also causes cobalamin malabsorption, which results in anemia. Reduced protein synthesis decreases hormone metabolism. Decreased HCl acid secretion causes hypochlorhydria. Destruction of α cells of the islets of Langerhans causes diabetes mellitus.
Which gastrointestinal secretion helps in the absorption of fatty acids and fat-soluble vitamins? Bile Ptyalin Lactase Peptidases
Bile Bile helps in the absorption of fatty acids and fat-soluble vitamins like vitamin A, vitamin D, vitamin E, and vitamin K. Ptyalin is an enzyme that helps in the initiation of starch digestion. Lactase helps in the conversion of lactose to glucose and galactose. Peptidases help in protein digestion.
Which gland secretes an alkaline fluid that contains bicarbonate? Parotid gland Adrenal gland Brunner's gland Sublingual gland
Brunner's gland Brunner's gland, which is present in the submucosa of the duodenum, secretes an alkaline fluid containing bicarbonate. The parotid and sublingual glands secrete saliva, which contains water, protein, mucin, inorganic salts, and salivary amylase; they do not secrete an alkaline fluid containing bicarbonate. Adrenal glands secrete hormones that regulate metabolism and help in managing stress; they do not secrete an alkaline fluid containing bicarbonate.
Inspection of an older patient's mouth reveals the presence of white, curd-like lesions on the patient's tongue. The nurse suspects that the condition is caused by what? Herpes virus Candida albicans Vitamin deficiency Irritation from ill-fitting dentures
Candida albicans White, curd-like lesions surrounded by erythematous mucosa are associated with oral candidiasis. Herpesvirus causes benign vesicular lesions in the mouth. Vitamin deficiencies may cause a reddened, ulcerated, swollen tongue. Irritation from ill-fitting dentures will cause friable, edematous, painful, bleeding gingivae. p. 846
What is the function of the area indicated in the figure? -Secreting insulin hormone -Concentrating bile pigment -Breaking down of white blood cells -Carrying absorbed products of digestion to the liver
Carrying absorbed products of digestion to the liver The arrow indicates the portal vein of the liver. The portal vein carries absorbed products of digestion directly to the liver. β cells of the islets of Langerhans secrete insulin hormone. The gallbladder concentrates and stores bile pigment. The function of Kupffer cells is to break down white blood cells. pp. 837-838
Upon reviewing the laboratory reports of a patient, the nurse finds that the patient has decreased release of pancreatic digestive enzymes. Which hormone deficiency does the patient likely have? Gastrin Secretin Cholecystokinin Gastric inhibitory peptide
Cholecystokinin Cholecystokinin stimulates the release of pancreatic digestive enzymes to break down proteins and fats. Therefore a deficiency of cholecystokinin can result in impaired secretion of pancreatic digestive enzymes. Secretin is secreted by the duodenal mucosa and stimulates pancreatic bicarbonate secretion. Gastrin stimulates gastric acid secretion and motility. Gastric inhibitory peptide inhibits gastric acid secretion and motility.
During an admission assessment, a patient states, "I had been having episodes of abdominal pain, so I had a surgery in which they made an opening into my common bile duct to remove stones." The nurse should document a history of what surgery? Colectomy Cholecystectomy Choledocholithotomy Choledochojejunostomy
Choledocholithotomy
Which substance stimulates secretion during the intestinal phase of gastric secretion? Mucus Chyme Gastrin Pepsinogen
Chyme The stimulus to secretion in the intestinal (hormonal) phase is the presence of chyme in the small intestine. Mucus is released during the cephalic phase of gastric secretion. Gastrin is released during the gastric phase of gastric secretion. Pepsinogen is released during the cephalic phase of gastric secretion.
A patient experiences impaired pancreatic function as a result of chronic pancreatitis. Which enzyme secretion will be affected in this patient? Lipase Ptyalin Sucrase Chymotrypsin
Chymotrypsin Chymotrypsin enzyme is secreted by the pancreas and helps in protein digestion. Therefore impaired pancreatic function can alter the secretion of chymotrypsin. Ptyalin is secreted by the salivary gland and helps initiate starch digestion. Lipase is secreted by the stomach and aids in fat digestion. Sucrase is secreted by the small intestine and it helps convert sucrose to glucose and fructose.
The nurse finds that a patient's gallbladder is not functioning well due to cholelithiasis and sludge. Which function will primarily be affected in the patient? Secretion of insulin Secretion of somatostatin Concentration and storage of bile Stimulation of pancreatic bicarbonate secretion
Concentration and storage of bile The gallbladder is a pear-shaped sac located below the liver, and its main function is to concentrate and store bile. Therefore damage to the gall bladder affects the concentration and storage of bile. Bile salts cause fat emulsification. The δ cells of the islets of Langerhans secrete somatostatin. Secretin hormone stimulates pancreatic bicarbonate secretion.
An older adult patient reports difficulty swallowing. The nurse recognizes that what age-related change is most likely causing this condition? -Decreased volume of saliva -Decreased protein synthesis -Decreased lower esophageal sphincter pressure -Decreased number and sensitivity of sensory receptors
Decreased lower esophageal sphincter pressure A patient with dysphagia has difficulty swallowing. Aging may decrease lower esophageal sphincter pressure and lead to difficulty swallowing. Decreased volume of saliva may cause dryness of the mouth. Decreased protein synthesis decreases drug and hormone metabolism. A decreased number and sensitivity of sensory receptors reduces pain sensitivity.
The nurse observes that many elderly patients experience constipation. What are causes of constipation in this population? Select all that apply. Decreased peristalsis Atrophy of gastric mucosa Decreased anal sphincter tone Decreased sensation to defecation Decreased blood flow to the stomach
Decreased peristalsis Decreased sensation to defecation Decreased peristalsis and decreased sensation to defecation lead to constipation and fecal impaction. Atrophy of gastric mucosa, decreased anal sphincter tone, and decreased blood flow to the stomach are also the changes associated with aging. Atrophy of gastric mucosa causes anemia and food intolerance. Decreased anal sphincter tone can cause fecal incontinence. Decreased blood supply to the stomach also causes anemia and food intolerance.
After assessing an older adult patient, the nurse suspects decreased drug metabolism. The nurse recalls that what age-related change causes this condition? Decreased muscular tone Decreased protein synthesis Decreased lipase production Decreased blood flow to stomach
Decreased protein synthesis Aging affects the protein synthesis process. Drug metabolism depends on protein binding capacity. The aging process decreases protein synthesis, which results in decreased drug metabolism. Decreased muscular tone causes abdominal distention. Decreased lipase production impairs fat absorption. Decreased blood flow to the stomach slows gastric emptying.
An older patient tells the nurse, "My mouth is dry a lot, and the food I eat tastes bland." The nurse suspects that the patient's concerns are caused by what age-related changes? Select all that apply. Increased appetite Decreased sense of smell Decreased bowel sensation Decreased salivary production Decreased number of taste buds
Decreased sense of smell Decreased salivary production Decreased number of taste buds Decreased taste bud function, decreased sense of smell, and decreased salivary production are anticipated physiologic changes related to a normal aging process. These natural occurrences can cause mouth dryness and a change in the sense of taste. For older adults, there is typically a decrease in appetite and decreased bowel sensation, which causes symptoms such as constipation. The decreased bowel sensation is not directly relevant to this patient's chief complaint.
A patient experiences an increase in parasympathetic stimulation. The nurse expects what clinical manifestation? Diarrhea Dysphagia Loss of appetite Reduced sensitivity to pain
Diarrhea Parasympathetic stimulation increases peristalsis movement in the body. Therefore increased stimulation of the parasympathetic system can result in diarrhea. Dysphagia occurs due to decreased lower esophageal sphincter pressure. Prolonged use of amphetamines causes loss of appetite as a side effect. Decreased number and sensitivity of sensory receptors reduces sensitivity to pain.
An 85-year-old patient reports a loss of appetite and no desire to eat at mealtimes. The nurse recalls what age-related changes that may be affecting the patient's appetite? Select all that apply. Difficulty swallowing food Decreased sense of smell Increased saliva production Loss of ability to feel satiety Diminished sense of taste, especially salty and sweet
Difficulty swallowing food Decreased sense of smell Diminished sense of taste, especially salty and sweet Several age-related changes may affect the older adult's appetite and ability to eat. Older adults have decreased numbers of taste buds and a decreased sense of smell. This diminishes the sense of taste, especially salty and sweet. Dysphagia is often the result of decreased lower esophageal sphincter pressure and decreased motility. The sense of satiety, a feeling or condition of being full after eating food, is not diminished with aging. Older adults have decreased (not increased) saliva production, which causes dry mouth and may interfere with swallowing.
Which enzyme causes activation of trypsinogen to trypsin? Lactase Maltase Peptidases Enterokinase
Enterokinase Enterokinase is secreted in the small intestine and triggers the activation of trypsinogen to trypsin. Lactase causes the conversion of lactose to glucose and galactose. Maltase causes the conversion of maltose to two glucose molecules. Peptidases help in protein digestion. p. 835
The nurse provides education to a group of nursing students about hormones that control gastrointestinal (GI) secretion and motility. The nurse should include information that which hormone that is found in gastric and duodenal mucosa is responsible for stimulating gastric acid secretion and motility? Gastrin Secretin Cholecystokinin Gastric inhibitory peptide
Gastrin Gastrin is the hormone activated in the stomach (and duodenal mucosa) by stomach distention that stimulates gastric acid secretion and motility and maintains lower esophageal sphincter tone. Secretin inhibits gastric motility and acid secretion and stimulates pancreatic bicarbonate secretion. Cholecystokinin allows increased flow of bile into the duodenum and release of pancreatic digestive enzymes. Gastric inhibitory peptide inhibits gastric acid secretion and motility. p. 836
While caring for a patient with cirrhosis, the nurse recalls that the liver performs what functions? Select all that apply. Storage of bile Glycogenolysis Storage of fat-soluble vitamins Secretion of amylase and lipase Synthesis and breakdown of cholesterol
Glycogenolysis Storage of fat-soluble vitamins Synthesis and breakdown of cholesterol The liver is responsible for many physiologic functions, including glycogenolysis, synthesis and breakdown of cholesterol, and storage of fat-soluble vitamins. The gallbladder stores bile. Amylase and lipase are secreted by the pancreas.
An older adult patient reports constipation to the nurse. What advice should the nurse give to this patient? Increase the intake of fluids. Decrease the intake of fluids. Discontinue physical activity. Take medication for constipation daily.
Increase the intake of fluids. Increasing the intake of fluids can help relieve constipation, which is commonly caused by aging. Decreasing the intake of fluids and being physically inactive can further increase the risk of constipation. Overuse of constipation medicines can make the body dependent on the drugs for defecation; therefore they are not advisable for daily use.
Which cells protect the mucosa of the small intestine? Chief cells Kupffer cells Parietal cells Intestinal goblet cells
Intestinal goblet cells The intestinal goblet cells secrete mucus and protect the mucosa of the small intestine. Chief cells secrete pepsinogen that helps in protein digestion. Kupffer cells carry out phagocytic activity. Parietal cells secrete hydrochloric acid, which acts as a catalyst for the conversion of pepsinogen to pepsin.
Which gastrointestinal secretion is essential for cobalamin absorption in the ileum? Maltase Enterokinase Intrinsic factor Hydrochloric acid
Intrinsic factor Intrinsic factor is essential for cobalamin absorption in ileum. Maltase helps convert maltose to two glucose molecules. Hydrochloric acid helps in the conversion of pepsinogen to pepsin. Enterokinase helps in the conversion of trypsinogen to trypsin.
The nurse is interviewing a patient with chronic constipation. The nurse finds that the patient performs a Valsalva maneuver to facilitate passing of feces. How is this maneuver helpful in aiding the elimination process? It stimulates peristalsis It increases intraabdominal pressure It stimulates the parasympathetic nerve fibers It initiates the gastrocolic and the duodenocolic reflex
It increases intraabdominal pressure The Valsalva maneuver involves contraction of the chest muscles with closed glottis and simultaneous contraction of the abdominal muscles. This increases the intraabdominal pressure, which facilitates defecation. The Valsalva maneuver does not stimulate peristalsis, stimulate the parasympathetic nerve fibers, or initiate the gastrocolic and duodenocolic reflex. Peristalsis, which propels the food towards the rectum, refers to the contraction of the smooth muscles of the intestine. The stimulation of parasympathetic nerve fibers from the sacral portions of the spinal cord relaxes the internal anal sphincter. It also contracts the rectal muscles leading to defecation. The gastrocolic and the duodenocolic reflex stimulate propulsive peristalsis in the large intestine.
While caring for a bedridden patient, a nurse notes that the patient's stools are lighter than the usual brown color. What could this finding indicate? Select all that apply. Liver failure Pancreatitis Stomach ulcers Colorectal cancer Biliary obstruction
Liver failure Biliary obstruction Bile is broken down in the intestine to form stercobilinogen and urobilinogen. Stercobilinogen gives a brown color to the feces. If the stools are light in color, it indicates there is reduced production of bile or bile is not reaching the intestine for breakdown. Liver cells form bile; therefore liver failure could cause decreased production of bile. Biliary tract obstruction prevents the bile from reaching the intestine. Pancreatitis causes impaired fat metabolism and therefore the stools are fatty and frothy. This is called steatorrhea. Stomach ulcers and colorectal cancers may cause bleeding in the GI tract, resulting in red-colored stools.
A patient is diagnosed with gastroesophageal reflux. The nurse recalls that reflux of gastric contents into the esophagus normally is prevented by which structure? Epiglottis Laryngeal pharynx Upper esophageal sphincter Lower esophageal sphincter
Lower esophageal sphincter The muscular layers contract (peristalsis) and propel the food to the stomach. There are two sphincters: the upper esophageal sphincter (UES) at the proximal end of the esophagus and the lower esophageal sphincter (LES) at the distal end. The LES remains contracted except during swallowing, belching, or vomiting. The LES is an important barrier that normally prevents reflux of acidic gastric contents into the esophagus. The epiglottis, laryngeal pharynx, and upper esophageal sphincter do not prevent reflux of gastric contents into the esophagus.
What is the function of the hormone gastrin? -Increasing the flow of bile into the duodenum -Maintaining lower esophageal sphincter tone -Stimulating the pancreatic bicarbonate secretion -Contracting the gallbladder and relaxing the sphincter of Oddi
Maintaining lower esophageal sphincter tone Gastrin is secreted by the gastric and duodenal mucosa. Its function is to maintain lower esophageal sphincter tone and aid in motility. Cholecystokinin increases the flow of bile into the duodenum. Secretin stimulates the pancreatic bicarbonate secretion. Cholecystokinin helps contract the gallbladder and relaxes the sphincter of Oddi. p. 836
When reviewing the gastrointestinal (GI) system, the nurse recalls that protein digestion begins with the release of what substance from chief cells? Chyme Gastrin Pepsinogen Acidic chyme
Pepsinogen Protein digestion begins with the release of pepsinogen from chief cells. The stomach's acid environment results in the conversion of pepsinogen to its active form, pepsin. Chyme secretion is triggered by the presence of food in the antrum of the stomach in the small intestine, which occurs in the intestinal phase. Release of gastrin is triggered by the presence of food in the antrum of the stomach and occurs in the gastric phase. Release of acidic chyme is triggered by the presence of chyme in the small intestine an also occurs in the intestinal phase.
A patient reports abdominal pain. The nurse checks the problem area by pressing in slowly and firmly over the painful site. The nurse withdraws the palpating fingers quickly. The patient experiences pain upon withdrawal. The nurse suspects what condition? Splenomegaly Cirrhosis of the liver Peritoneal inflammation Presence of an abdominal mass
Peritoneal inflammation Rebound tenderness is a characteristic sign of peritoneal inflammation. It can be tested by pressing the painful area deeply and firmly and then withdrawing the fingers quickly. Withdrawal of the palpating fingers produces pain. Rebound tenderness is not indicative of cirrhosis, an enlarged spleen, or presence of an abdominal mass. These may be tender on deep palpation.
The nurse is examining four patients. The nurse anticipates a prescription for magnetic resonance imaging (MRI) for which patient? Patient A: Showing s&s of colorectal cancer Patient B: Presence of pacemaker and sx of hepatobiliary disease Patient C: Showing s&s of hep C Patient D: Showing s&s of stomach ulcerations
Pt A Magnetic resonance imaging (MRI) is a noninvasive procedure. It involves the use of radiofrequency waves and a magnetic field to diagnose colorectal cancer; therefore patient A requires an MRI. Magnetic resonance imaging is contraindicated in a patient with a pacemaker, because the powerful magnetic and radiofrequency fields generated during imaging may damage the pacemaker. A fibro test is performed to diagnose hepatitis C. Esophagogastroduodenoscopy (EGD) is performed to diagnose stomach ulcerations.
The nurse reviews the gastrointestinal secretion findings of four patients. The nurse recognizes that which finding may indicate a decreased total amount of pancreatic secretions? Pt A: salivary amylase-1500mL Pt B: chymotrypsin-300mL Pt C: Enterokinase-3000mL Pt D: Bile-1000mL
Pt B Chymotrypsin is secreted by the pancreas. An amount of 700 mL of pancreatic secretions is a normal daily amount. Therefore secretion of 300 mL of chymotrypsin is abnormally low and may cause protein indigestion. Salivary amylase is secreted by the salivary glands. The release of 1500 mL is the daily amount of salivary gland secretions. Enterokinase is released by the small intestine. Secretion of 3000 mL of small intestine secretions is normal. Bile is released by the liver and gallbladder. Secretion of 1000 mL of bile per day is a normal finding; it helps in the emulsification of fats
The nurse reviews the laboratory reports of four patients and identifies that which patient is at high risk of infections? Pt A: Damaged chief cells Pt B: damaged parietal cells Pt C: damaged kupffer cells Pt D: damaged delta cells of pancreas
Pt C Kupffer cells help to remove bacteria and toxins from the blood by phagocytosis. Therefore damage to the Kupffer cells results in impaired removal of bacteria from the body and puts the patient at high risk for infections. Chief cells help secrete pepsinogen; damage to chief cells does not increase the risk of infection. Parietal cells secrete hydrochloric acid, water, and intrinsic factor; damage to the parietal cells does not increase the risk of infection. The δ cells of the pancreas produce somatostatin; damage to the Δ cells of the pancreas does not increase the risk of infection.
After assessing four patients, the nurse identifies that the Valsalva maneuver may benefit which patient? Pt A: recent head injury Pt B: hemorrhoids Pt C: constipation Pt D: recent eye surgery
Pt C The Valsalva maneuver is used to facilitate defecation. It involves contraction of the chest muscles on a closed glottis, and simultaneous contraction of the abdominal muscles. It increases intraabdominal pressure, thereby helping eliminate the stool. The Valsalva maneuver is recommended for constipation. The Valsalva maneuver is contraindicated for patients who have head injuries, because it may increase intracranial pressure. The Valsalva maneuver increases the pressure inside the abdomen and pelvis. It pushes the blood in the rectal veins into the anus and may worsen hemorrhoids. The Valsalva maneuver is not recommended for a patient who has recently undergone eye surgery, because it may increase intraocular venous pressure, which may rupture the retinal capillaries.
The nurse provides information to a patient related to obtaining a stool specimen for occult blood. The instructions should include keeping the diet free of what item for 24-48 hours before the test? Shellfish Red meat Fatty foods Iron supplements
Red meat If the stool is Hemoccult-positive, it contains trace blood. A false-positive reading may occur if the patient has ingested significant amounts of red meat in the 24 or 48 hours before the test. Iron supplements, shellfish, and increased intake of fatty foods will not cause false-positive findings on a test for occult blood.
The nurse reviews the gastrointestinal (GI) process and recalls that the stomach performs what functions? Select all that apply. Secretion of bile Secretion of saliva Absorption of proteins Secretion of pepsinogen Secretion of hydrochloric acid Disintegration of fats into fatty acids
Secretion of pepsinogen Secretion of hydrochloric acid The parietal cells present in the fundus of the stomach secrete hydrochloric acid, which serves as protection against organisms present in food. The chief cells secrete pepsinogen. Proteins are absorbed in the small intestine. Secretion of saliva is performed by the salivary glands present in the oral cavity. Fats are broken down into fatty acids in the small intestine with the help of digestive enzymes. Bile is secreted by the liver.
The nurse reviews the medical record of an older patient and notes food intolerance and signs of anemia. The nurse identifies that the age-related changes are associated with which part of the gastrointestinal (GI) system? Liver Stomach Esophagus Small intestine
Stomach Age-related changes in the stomach include atrophy of the gastric mucosa and decreased blood flow. The results are food intolerance and signs of anemia (as a result of cobalamin malabsorption), and slower gastric emptying. Impaired liver function can result in decreased drug and hormone metabolism. Improper functioning of the esophagus can cause epigastric distress. Impaired functional activity of the small intestine can slow the intestinal tract and cause delayed absorption of fat-soluble vitamins. p. 840
A patient is scheduled for a barium swallow test to diagnose abnormalities in the esophagus. Which instruction should the nurse include when preparing the patient for this procedure? -Avoid smoking 1 hour before the test. -Maintain a clear liquid diet for 8 hours before the test. -Stools may remain white for up to 72 hours after the test. -It is important to lie still during the 30 minutes it will take for test to be completed.
Stools may remain white for up to 72 hours after the test. A barium swallow study is a radiographic study in which the patient drinks a contrast medium. The stool may be white up to 72 hours after the procedure as a part of elimination of the contrast. Patients should avoid smoking after midnight. The patient should be NPO for at least 8 hours before the test. The patient will assume various positions on the x-ray table.
While teaching about the large intestine to a group of nursing students, the nurse explains that various microbes, mainly bacteria, live symbiotically in the large intestine. What are the functions of these microbial floras? Select all that apply. Breakdown of starch Suppression of flatus Synthesis of vitamin K Synthesis of vitamin D Breakdown of amino acids
Synthesis of vitamin K Breakdown of amino acids Bacteria in the colon live symbiotically. The bacteria in the colon are responsible for the breakdown of amino acids for better absorption. These bacteria also synthesize vitamin K. Bacteria are not capable of breaking down starch or synthesizing vitamin D. Bacteria also aid the production of flatus; they do not suppress it.
Which muscle guards the exit from the stomach? Rectus muscle Abdominal muscle Pyloric sphincter muscle Cricopharyngeal muscle
The pyloric sphincter guards the exit from the stomach. The rectus muscle helps flex the torso and spine in the abdominal region. Abdominal muscles hold the abdominal organs in place. The cricopharyngeal muscle helps in peristaltic movement of the pharynx. p. 835
A patient reports that a recent motor vehicle accident caused the patient to feel extremely scared. The patient reports being constipated since the day of the accident. The nurse suspects that what alteration in the function of the gastrointestinal (GI) system is causing the constipation? -The patient is too nervous to eat or drink, causing less stool production. -The circulation in the GI system was increased, so less waste is removed. -The sympathetic nervous system (SNS) was activated, so the GI tract was slowed. -The parasympathetic nervous system was stimulated, causing a decrease in peristalsis.
The sympathetic nervous system (SNS) was activated, so the GI tract was slowed. The constipation most likely is related to the sympathetic nervous system activation from the stress related to the accident. SNS activation can decrease peristalsis. Even without oral intake for a short time, stool will be formed. The parasympathetic system stimulates peristalsis. The circulation to the GI system is decreased with stress. p. 833
After reviewing a patient's laboratory report the nurse finds that the blood glucose level is 140 mg/dL. Which cellular function of the islets of Langerhans is impaired in the patient? The F cells The β cells The δ cells The α cells
The β cells Normal blood glucose levels range between 82 and 110 mg/dL. Therefore a blood glucose level of 140 mg/dL is elevated and indicates diabetes mellitus. Insulin hormone regulates glucose levels and the β cells of the islets of Langerhans secrete insulin hormone. Impaired insulin production from the damaged β cells of the islets of Langerhans increases the glucose levels in the body. The F cells of the islets of Langerhans secrete pancreatic polypeptide. The δ cells of the islets of Langerhans secrete somatostatin. The α cells of the islets of Langerhans secrete glucagon.
The nurse discusses the process of digestion with a patient and explains that microorganisms exist in the large intestine. What are the functions of the microorganisms? Select all that apply. Secretion of mucus Absorption of water Vitamin K synthesis Neutralize acid in the fecal contents Breakdown of proteins not digested in the small intestine
Vitamin K synthesis Breakdown of proteins not digested in the small intestine Microorganisms in the colon are responsible for the breakdown of proteins not digested or absorbed in the small intestine. These amino acids are delaminated by the bacteria, leaving ammonia, which is carried to the liver and converted to urea, which is excreted by the kidneys. Bacteria in the colon also synthesize vitamin K and some of the B vitamins. Microorganisms do not secrete mucus, absorb water, or neutralize acid in fecal contents.