Exam 1: Digestion
How to care for nausea:
-Avoid Greasy food & Sweet Foods -BRAT Diet (Bananas, Rice, Applesauce, Toast) -Eating small/frequent meals -Avoid large amounts of Water before meals -Stay hydrated with Sports Drinks/Pedialyte
What can affect motility?
-Can be affected by food intake, bacteria, consistency of stools (quicker it moves more liquid the stool is because it is not able to reabsorb) (if it moves too slowly its more formed or constipated) -Also be effected by inflammation, tumors, obstructions, stress, not pooping when you feel the urge to go (common in children: encopresis)
GERD nursing diagnosis
-Ineffective health maintenance -Acute Pain -Readiness for enhanced nutrition -Dysfunctional gastrointestinal motility **PRIORIRTY is to relieve discomfort associated with GERD**
How to care for Heartburn:
-OTC antacids, acid reducers -Decreasing pressure on abdomen -Avoid eating before going to bed -Avoid spicy or acid foods, cigarettes
when dealing with nausea you should limit fluid intake how early before and after meals
1 hr
if a patient has heartburn..when should they stop eating before bed
2-3 hrs before bed
normal level of lipase is between
20 and 180
Pancreatitis etiology
1. Biliary tract disease 2. Alcohol abuse 3. Infections 4. Hypercalcemia 5. drugs
Turner's sign
Flank--greyish blue. bleeding behind intestinal layers. (turn around to see your flanks) Seen with pancreatic necrosis
Examples of Alterations & Manifestations of Digestion:
Nausea, Vomiting, Anorexia, GERD, Hepatitis, Malabsorption (intestines can't absorb nutrients = weight loss, cramps, bone pain), Maldigestion (isn't enough chime to put out digestion enzymes to break down food) Pancreatitis (pain, nausea, vomiting, stool color change = white or clay), Pyloric Stenosis (seen in infant 1wk to 5 months, sphincter is very tight and won't allow food or formula to move into intestines. You'll see emesis/puking after feeding)
A nurse is checking the nasogastric tube position of a client receiving a long term therapy of Omeprazole (Prilosec) by aspirating the stomach contents to check for the PH level. The nurse proves that correct tube placement if the PH level is? A.5 B.6.3 C.6.5 D.7
a.5 Option A: Gastric placement is indicated by a pH of less than 4, but may increase to between pH 4-6 if the patient is receiving acid-inhibiting drugs.
Examples of antacids
aluminum hydroxide, calcium carbonate, milk of magnesia, sodium bicaronate
What test can be performed non fasting?
amlyase
what is a serum blood test that measures the amount of ___<_ secreted from the pancreas
amylase
A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client: A.Relief of nausea and vomiting. B.Decrease diarrheal episodes. C.The absence of constipation. D.Relief from GERD.
d. relief from gerd
H2-Receptor Blockers Side Effects
dizziness, confustion, hypotension, impotence, breast enlargement (common in males) & tenderness, raise toxicity levels of other medications
Barrett Esophagus
esophagus cancer complications of gerd
Prevention of Gerd:
· Eat small more frequent meals, Avoid foods that stimulate acid production (acidic foods & spicy foods & caffeine & greasy foods & & tomatoes & caffeine & alcohol), avoid eating close to bedtime, elevate head of bed to prevent pressure on lower esophageal sphincter, avoid tight fitting clothing, avoid smoking/alcohol, maintain near or ideal body weight
What do promotility agents do?
· Enhance esophageal clearance and gastric emptying by increasing tone of lower sphincter and contraction of the stomach which helps moves thing along so things aren't sitting in the stomach · Used to treat regurgitation, indigestion, and nighttime symptoms
What are some examples of collaborative therapies for digestion?
· Healthy Digestive Diet: Low in Fat, Cholesterol, Sugar. Includes a variety of fruits, vegetables, grains, and protein. · Enteral Nutrition (Tube Feeding) - If a patient cannot get adequate nutrition orally - Complications: Aspiration, Diarrhea - Nurse can put in G tube not Duo tube (has wire in in the tube) - Xray to determine place. Check gastric contents & PH. Needs to be under 4. - Check before every feeding/meds. If continuous the residual should be checked every 4 hrs unless status change. - If tube feeding be at 45 degree sitting up.
Manifestations of GERD:
· Heartburn after meals, when bending over when reclining, pain in swallowing regurgitation of sour material into mouth, atypical chest pain, tooth erosion aspiration can cause respiratory symptoms cough/hoarseness, esophageal strictures (scars, edema, spasms, dysphagia), barrett esophagus
Nonpharmcologic therapy for digestionL
· Increased consumption of fruits vegetables, fiber · Increased exercise · Hypnotherapy · Acupuncture · Herbal Remedies:peppermint oil, turmeric, ginger · Probiotics
Examples of Promotility Agents
· Metoclopramide (Reglan)
Contraindications for Promotility Agents:
· Not recommended for long term use · Contraindicated: sensitivity or intolerance to a drug, lactation, allergy to sulfa, ileus, and G obstruction, and perforation
Risk Factors for GERD
· Obesity, Excessive Alcohol Consumption, Smoking Hiatal Hernia, Pregnancy · Increased Risk: Premature Birth, Male, Neurologic Impairment, Trisomy 21, Bronchopulmonary dysplasia, esophageal atresia
The nursing assessment for digestions consists of:
· Observations (health history, energetic/pale/changes in appetite, bowel changes, pain, age, environment, current therapies in use) · Physical Assessment: Inspect, Auscultation, Percussion, Palpation · Assess for signs of malnutrition throughout
Examples of PPIS
· Omperazole (Prilosec) · Lansoprazole (Prevacid) · Pantoprazole (Protonix)
Side effects of PPIs (proton pump inhibitors)
· Omperazole (Prilosec)- should not be given to pregnant women due to harm to the fetus -· This drug class causes osteoporosis/hip fractures esp in women who smoke and interferes with the absorption of calcium and b12 and could cause anemia) · Should be administered on empty stomach 30 minutes before breakfast · Could cause cough in elderly clients · Long term use will lead to deficiencies of vitamins & minerals
How do H2 receptor blockers work?
· Reduces acid production by blocking the release of histamine. Which reduces the release of hydrogen ions by the parietal cells - increases PH in the stomach.
What to know about Antimetics
· Take before the nausea event usually 1 hour before* · Anticholinergic effect .. dries you out · Avoid alcohol · Cannabinoids- Dronabinol/Marinol *not used in pt's w/ psych history* · Neurokinin Receptor Agonists- Apreitant/Emend *not for long term/interacts with warfarin* (blood levels)
Diagnostic Tests for Digestion:
· Upper GI Series (Barium Swallow) - NPO for 8-12 hrs. Given 6-18oz of Barium to Swallow. Post procedure: encourage fluids & maybe even a laxative. No smoking 24-48 hrs before. · Endoscopy: Light & Camera on Scope to check for tumors/erosions/anything altering mucous membrane lining. Invasive Procedure. NPO. Anesthesia to numb throat & Sedation. Check for Gag Reflux. · Abdominal XRay · CT Scan · Amylase: 60-160 Smogyi units/dl (pain related to pancreas) can be drawn at any time. Will peak within 48 hrs. · Lipase: 20-180 IU/I pt does have to fast for 8 hrs. Elevation is diagnostic for pancreatitis.
What do antimetics do?
· Used to prevent or control nausea and vomiting
How is GERD diagnosed?
· history, physical exam, diagnostic tests
Treatment for GERD
· infant treatments change in feedings/position changes; children & adolescents: lifestyle changes similar to those used in adults; in pregnant women symptoms worsen as weight gain & fetal size increases, increases maternal age, existing gerd, AVOID omeprazole in pregnant women due to harming the fetus; IN OLDER adults may be asymptomatic, have atypical symptoms (cough/wheezing, weight loss, nausea), antacids may not be useful, lifestyle and dietary change may be difficult to make, PPIS increases risk of community pneumonia & h2 increase risk of osteoporosis and hip fractures
antimetics
*END IN -AZINE* chlorpromazine (THRAZINE) perphenazineprochlorperazine(COMPAZINE) 5-HT3 RECEPTOR ANTAGONISTS **END IN -SETRON* dolasetron (ANZEMET) ondansetron (ZOFRAN)
ACID REDUCING: PROTON PUMP INHIBITORS
*END IN -PRAZOLE* esomeprazole (NEXIUM) lansoprazole (PREVACID) omeprazole (PRILOSEC) pantoprazole (PROTONIX) raberprazole (ACIPHEX)
ACID REDUCING: HISTAMINE H2 ANTAGONISTS
*END IN -TIDINE* cimetidine (TAGAMET) famotidine (PEPCID) nizatidine (AXID) ranitidine (ZANTAC)
ACID REDUCING: PROTON PUMP INHIBITORS*WARNINGS*
*prolonged use may cause decreased ability to absorb vitamin B12 resulting in pernicious anemia* *should be given PRIOR to meals*
Complications with TPN
- Complications: Glucose Intolerance, Hyperlipidemia, Fluid Overload, Electrolyte Imbalance, Infection Mechanical Complications: Mostly related to insertion of catheter itself such as pneumothorax, brachial plexus injury, improper positioning, thrombus/blood clot form at end of catheter, leaking. Could cause lung collapse. NEED CHEST XRAY. Needs to be in superior vena cava
Lifestyle Modifications - GERD:
- Elevate head of bed - Diet: Avoid foods that decrease LES pressure (see prior table) =Avoid foods that have a direct irritant effect -Eat small meals; -avoid eating within 3 hours of laying down -Weight reduction if appropriate
An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1. Tremors 2. Dizziness 3. Confusion 4. Hallucinations
3. Confusion Rationale: Cimetidine is a histamine (H2)-receptor antagonist. Older clients are especially susceptible to central nervous system side effects of cimetidine. The most frequent of these is confusion. Less common central nervous system side effects include headache, dizziness, drowsiness, and hallucinations.
normal amylase levels are between
69 and 160
Dr. Smith has determined that the client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D
A. Hepatitis A Option A: Hepatitis A is transmitted by the fecal-oral route via contaminated food or infected food handlers. Options B, C, & D: Hepatitis B, C, and D are transmitted most commonly via infected blood or body fluids.
Nurse Oliver checks for residual before administering a bolus tube feeding to a client with a nasogastric tube and obtains a residual amount of 150 mL. What is the appropriate action for the nurse to take? A. Hold the feeding B. Reinstill the amount and continue with administering the feeding C. Elevate the client's head at least 45 degrees and administer the feeding D. Discard the residual amount and proceed with administering the feeding
A. Hold the feeding anything over 100 needs to be held
A geriatric patient is prescribed with Cimetidine (Tagamet) for the treatment of heartburn. Which of the following is the most frequent CNS side effect? A.Agitation. B.Drowsiness. C.Headache. D.Somnolence
A. agitation
The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy? A."The cimetidine (Tagamet) will cause me to produce less stomach acid." B."Sucralfate (Carafate) will change the fluid in my stomach." C."Antacids will coat my stomach." D."Omeprazole (Prilosec) will coat the ulcer and help it heal."
A."The cimetidine (Tagamet) will cause me to produce less stomach acid."
A patient is about to start taking aluminum hydroxide to reduce gastric acid. Which of the following instructions should you include when talking with the patient about taking this drug? Select all that apply. A. Take it w/a large meal B. Chew the tablets thoroughly C. Drink 4 oz of water after taking it. D. Increase fluid and fiber intake. E. Take it once daily.
B. Chew thoroughly. C. Drink 4 oz of water after taking it D. Increase fluid and fiber intake. Patients can take it up to 4 time day.
You are about to administer ondansetron to a PT to prevent anesthesia induced nausea and vomiting. You prepare to monitor the PT for which of the following adverse effects of this drugs? A. Bronchospasm B. Dizziness C. Hypertension D. Anxiety
B. Dizziness
The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication: A.30 minutes after meals B.30 minutes before meals C.With each meal D.Single dose at bedtime.
B.30 minutes before meals
Which of the following best describes the method of action of medications, such as ranitidine (Zantac), which are used in the treatment of peptic ulcer disease? A.Neutralize acid B.Reduce acid secretions C.Stimulate gastrin release D.Protect the mucosal barrier
B.Reduce acid secretions
Which of the following condition can you safely administer Metoclopramide (Reglan)? A.Patient with bowel obstruction. B.Patient with gastrointestinal hemorrhage. C.Patient undergoing radiation. D.Patients with pheochromocytoma
C Patient undergoing radiation.
A patient is about to start taking omperazole to treat a duodenal ulcer. Which of the following instructions should you include when talking with the patient? A. Take it with food B. Avoid using aluminum based antacids C. Consume adequate vitamin D and calcium D. Do not drink grapefruit juice
C. Consume adequate vitamin D and calcium
urse Victoria is teaching a group of middle-aged men about peptic ulcers. When discussing risk factors for peptic ulcers, the nurse should mention: A.A history of hemorrhoids and smoking B.A sedentary lifestyle and smoking C.Alcohol abuse and smoking D.Alcohol abuse and a history of acute renal failure
C.Alcohol abuse and smoking
Which of the following digestive enzymes aids in the digesting of starch? a) Bile b) Trypsin c) Amylase d) Lipase
C.Amylase Explanation: Digestive enzymes secreted by the pancreas include trypsin, which aids in digesting protein; amylase, which aids in digesting starch; and lipase, which aids in digesting fats. Bile is secreted by the liver and is not considered a digestive enzyme.
When a client has peptic ulcer disease, the nurse would expect a priority intervention to be: A.Assisting in inserting a Miller-Abbott tube B.Assisting in inserting an arterial pressure line C.Inserting a nasogastric tube D.Inserting an I.V.
C.Inserting a nasogastric tube
A female client being seen in a physician's office has just been scheduled for a barium swallow the next day. The nurse writes down which instruction for the client to follow before the test? A. Fast for 8 hours before the test B. Eat a regular supper and breakfast C. Continue to take all oral medications as scheduled D. Monitor own bowel movement pattern for constipation
Correct Answer: A. Fast for 8 hours before the test Option A: A barium swallow is an x-ray study that uses a substance called barium for contrast to highlight abnormalities in the gastrointestinal tract. The client should fast for 8 to 12 hours before the test, depending on physician instructions.
For Jayvin who is taking antacids, which instruction would be included in the teaching plan? A. "Take the antacids with 8 oz of water." B. "Avoid taking other medications within 2 hours of this one." C. "Continue taking antacids even when pain subsides." D. "Weigh yourself daily when taking this medication."
Correct Answer: B. "Avoid taking other medications within 2 hours of this one." Option B: Antacids neutralize gastric acid and decrease the absorption of other medications. The client should be instructed to avoid taking other medications within 2 hours of the antacid.
When planning home care for a client with hepatitis A, which preventive measure should be emphasized to protect the client's family? A. Keeping the client in complete isolation B. Using good sanitation with dishes and shared bathrooms C. Avoiding contact with blood-soiled clothing or dressing D. Forbidding the sharing of needles or syringes
Correct Answer: B. Using good sanitation with dishes and shared bathrooms Option B: Hepatitis A is transmitted through the fecal-oral route or from contaminated water or food. Measures to protect the family include good handwashing, personal hygiene and sanitation, and the use of standard precautions.
The nurse is performing an abdominal assessment and inspects the skin of the abdomen. The nurse performs which assessment technique next? A. Palpates the abdomen for size B. Palpates the liver at the right rib margin C. Listens to bowel sounds in all four quadrants D. Percusses the right lower abdominal quadrant
Correct Answer: C. Listens to bowel sounds in all four quadrants Option C: The appropriate sequence for abdominal examination is inspection, auscultation, percussion, and palpation. Auscultation is performed after inspection to ensure that the motility of the bowel and bowel sounds are not altered by percussion or palpation. Therefore, after inspecting the skin on the abdomen, the nurse should listen for bowel sounds.
Pierre, who is diagnosed with acute pancreatitis, is under the care of Nurse Bryan. Which intervention should the nurse include in the care plan for the client? A. Administration of vasopressin and insertion of a balloon tamponade B. Preparation for a paracentesis and administration of diuretics C. Maintenance of nothing-by-mouth status and insertion of nasogastric (NG) tube with low intermittent suction D. Dietary plan of a low-fat diet and increased fluid intake to 2,000 ml/day
Correct Answer: C. Maintenance of nothing-by-mouth status and insertion of nasogastric (NG) tube with low intermittent suction Option C: With acute pancreatitis, the client is kept on nothing-by-mouth status to inhibit pancreatic stimulation and secretion of pancreatic enzymes. NG intubation with low intermittent suction is used to relieve nausea and vomiting, decrease painful abdominal distention, and remove hydrochloric acid.
The nurse is monitoring a female client with a diagnosis of peptic ulcer. Which assessment findings would most likely indicate perforation of the ulcer? A. Bradycardia B. Numbness in the legs C. Nausea and vomiting D. A rigid, board-like abdomen
D. A rigid, board-like abdomen
The older adult patient presents to the emergency department complaining of severe vomiting for 3 days. The nurse knows which is the major complication of continuous vomiting? A. Weight loss B. Cardiac dysrhythmias C. Aspiration of vomitus D. Dehydration
D. dehydration
Which of the following statements describes the action of antacids? A.Antacids block the production of gastric acid B.Antacids enhance the action of acetylcholine C.Antacids block dopamine D.Antacids neutralize gastric acid
D.Antacids neutralize gastric acid
Which of the following tests can be used to diagnose ulcers? Barium swallow Abdominal x-ray Esophagogastroduodenoscopy (EGD) Computed tomography (CT) scan
Esophagogastroduodenoscopy (EGD) The barium swallow could locate a gastric ulcer.
When is TPN used?
GI tract cannot be used for ingestion, digestion, and absorption of essential nutrients. After surgery/trauma Or w/ a seriously undernourished PT
What is found in the LUQ?
Left Lobe of Liver, Spleen, Stomach, Body of Pancreas, Left Adrenal Gland, Portion of Left Kidney
What test needs an 8hour fast?
Lipase
What is found in the RUQ?
Liver & Gallbladder, Duodenum, Portions of Ascending and Transverse Colon
What's found in the RLQ?
Lower Pole of Right Kidney, Cecum, Appendix, Right Ureter, Right Ovary
What's found in the LLQ?
Lower pole of left kidney, Sigmoid Colon, Portion of Descending Colon, Bladder ( in distended, uterus (if enlarged), left ureter
What can effect absorption?
Medical or surgical conditions can hinder absorption (B12/Lactose Intolerance, Celiac's)
A client has just taken a dose of trimethobenzamide. The nurse determines that the medication has been effective if the client reports which outcome?
Nausea and vomiting has been relieved.
What medication can harm the fetus?
Omeprazole (Prilosec)
A 40-year-old male client has been hospitalized with peptic ulcer disease. He is being treated with a histamine receptor antagonist (cimetidine), antacids, and diet. The nurse doing discharge planning will teach him that the action of cimetidine is to: A. Reduce gastric acid output. B. Protect the ulcer surface. C. Inhibit the production of hydrochloric acid (HCl). D. Inhibit vagus nerve stimulation
Option A: Reduce gastric acid output. These drugs inhibit the action of histamine on the H2 receptors of parietal cells, thus reducing gastric acid output.
In what position should a pt be in to assess the abdomen?
Place Patient in Supine with Pillow behind head & knees. Make sure pt is comfortable and nurse is able to visualize and assess pt.
The client with peptic ulcer disease has been prescribed to take cimetidine. The nurse determines that which is the primary action of this medication?
Protects the gastric mucosa
What do Proton Pump Inhibitors (PPIS) do?
Reduce/block gastric secretions, promote healing, relieve symptoms
Important Points Related to Antacids
Sodium Bicarbonate/Alka Seltzer (Has baking soda need to be watched with PT's with heart failure) & Fluid retention They will alter absorption of other meds. Need to be given 2 hrs before or after other meds.
What medication needs to be watched for fluid retention, contraindicated for pts with heart failure and pregnant pts?
Sodium bicarbonate (Baking soda, Alka-seltzer)
What foods/drinks should be avoided with GERD?
Spicy foods, caffiene, alcohol, Acidic foods, tomatoes, greasy food
The primary health care provider has written a prescription for ranitidine, for a client with gastrointestinal reflux disease. The nurse is explaining how this medication works to treat this disease. Which explanation should the nurse give?
The medication suppresses acid secretion by blocking H2 receptors.
Fundoplication
a surgical technique used to suture the fundus of the stomach around the esophagus to prevent reflux
A client has been prescribed with Sucralfate (Carafate) for the treatment of gastric ulcer. The nurse instruct the client that this medication is taken? A.1 hour before meals. B.1 hour after meals. C.At the same time with an antacid. D.Lunch time
a. 1 hour before meals
A patient with gastroesophageal reflux disease (GERD) undergoes esophagoscopy that reveals increased esophageal erosion. Which is the priority intervention that the nurse teaches this patient? a. Avoiding eating 3 hours prior to bedtime b. Sitting upright for 30 minutes after eating c. Eating slowly and chewing foods thoroughly d. Restricting caffeine and chocolate in the diet
a. Avoiding eating 3 hours prior to bedtime
What nutritional information should be included in the teaching plan for a patient diagnosed with gastroesophageal reflux disease (GERD)? Select all that apply. a. Limit caffeine b. Eat a peppermint c. Decrease chocolate intake d. Eat three small meals a day e. Avoid drinking fluids at meals
a. Limit caffeine. c. Decrease chocolate intake.
A client has been given Ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative patient? AVomiting. B..Incisional pain. C.Abdominal infection. D.Atelectasis
a. vomiting
The nurse assesses a client who is reporting mild abdominal cramping. How will the nurse proceed with assessment of this client?a) Auscultation, inspection, percussion, palpation b) Inspection, auscultation, percussion, palpation c) Palpation, inspection, percussion, auscultation d) Inspection, percussion, auscultation, palpation
b) Inspection, auscultation, percussion, palpation
what diet should be used for nausea
brat diet
Cullen's sign
bruising in the skin around the umbilicus. Seen with pancreatitis--internal bleeding.
An older client has recently been taking cimetidine. The nurse should monitor the client for which most frequent central nervous system side effect of this medication?
confusion
digestion involves:
consumption, elimination, and prevention
A nurse is giving a nothing per orem instructions to a malnourished client with diarrhea and frequent abdominal pain episodes which is about to receive a Total Parenteral Nutrition. Which statement made by the nurse is the most appropriate? A."It will help in your weight loss". B."It can assure you that you feel better after receiving TPN". C."It will decrease your diarrhea and your bowel can rest". D."It will give you less time in the hospital".
c. It will decrease your diarrhea and your bowel can rest".
A patient is scheduled to undergo 24-hour ambulatory esophageal pH monitoring. When teaching this patient about the procedure, what does the nurse instruct the patient to do? a. Take antacids to minimize acid reflux discomfort b. Consume a clear liquid diet while the probe is in place .c. Keep a record of all symptoms and activities during the test d.Avoid driving because sedation is required during the procedure
c. Keep a record of all symptoms and activities during the test
The nurse is counseling a patient who has been diagnosed with mild gastroesophageal reflux disease (GERD). What does the nurse teach the patient initially about managing this condition? a. Changing sleeping positions b. Using proton pump inhibitors c. Taking over-the-counter antacids d. Altering dietary and eating habits
d. Altering dietary and eating habits
What is the priority nursing intervention for a client receiving an antiemetic? A.Monitor intake and output. B.Keep items far away from the bed. C.Give the client privacy by letting him walking around the room. D.Keep bed in low position with side rails up.
d. Keep bed in low position with side rails up. Antiemetics can cause drowsiness; hence the priority nursing intervention is to protect the client from injury such as raising the side rails and keeping the bed in low position.
Diagnostic Tests for Gerd:
· Barium Swallow, Upper Endoscopy, Bernstein Test, 24 Hr Ambulatory Ph Monitoring, Esophageal Manometry
The client has been taking omeprazole for 4 weeks. The nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?
heartburn
The nurse is collecting data from a client who is taking pantoprazole. The nurse determines that the medication is most effective if the client states relief of which symptom?
heartburn
Hepatitis
inflammation of the liver
pancreatitis
inflammation of the pancreas
What are the proper steps to assessing the abdomen
inspect, auscultation, palpation, then percussion
Total Pareteral Nutrition -TPN
is a form of intravenous feeding
Lipase
is another serum blood test that measures the secretion of lipase by the pancreas
If percussing and dont hear hollow sound (tympany) and sounds like dull thud
it could mean intestines are full of stool or liver is enlarged
fluid is absorbed in the
large intestine
modifiable risk factors for digestion
maintain healthy weight, eliminating smoking (slows down gi tract), limiting alcohol (speeds up GI tract & wont absorb nutrients), avoid citrus & chocolate & caffeine for digestive disorders
motility
moves food & fluid from mouth to anus
Absorption
moves nutrients from outside the GI tract to inside the body/bloodstream for distribution.
Antacids
neutralize the acids in the stomach
barium swallow
radiographic examination of the esophagus, stomach, and small intestine after oral administration of barium sulfate
examples of H2 receptor blockers
ranitidine/zantac (off the market due to cancer) cimetidine/tagamet, famotidine/pepcid
electrolytes are absorbed in the
small intestine
what do you need to be aware of with ng tubes
sucking out fluids/electrolytes check lab values and intake & output, signs of dehydration
sleep affects metabolic processes in the body which can lead to digestion issues t or f
true
most digestive disorders have genetic connections t/f
true which becomes a risk factor
diet for digestion:
water, fiber, lean meats, fruits, and vegetables, whole grains broiled **washing hands & produce** **kept at appropriate temps** avoid alcohol & caffeinated beverages
Malnutrition symptoms
weakness, easy fatigability, flaky dermatitis, cold intolerance, ankle swelling
pyloric stenosis is more common is
white first born infants
Gerd Lifespan Considerations
· <1 yr (less than 1 yr) spitting up a lot, irritable, poor weight gain, arch back during feeding; Respiratory: choking, wheezing coughing Age 1-5: vomit, abdominal pain, poor weight gain refusal to eat, aversion to food; Older children and adolescents are similar to adults.
Examples of Antimetics
· Antihistamines-meclizine/antivert dimenhydrinate/Dramamine · Serotonin Receptor Agonists- Ondansetron (Zofran) · Dopamine Agonists- Prochlorperazine/Compazine, Haloperidol/Haldol · Cannabinoids- Dronabinol/Marinol · Neurokinin Receptor Agonists- Apreitant/Emend
Gerd Assessment
· Assessment: Observation & Interview -Health history -Manifestations: heartburn, atypical chest pain, food tolerance -Assess regurgitation when, when symptoms increase, difficulty in swallowing · Physical Assessment: -abdominal distention, epigastric tenderness, bowel sounds -mouth, throat, teeth, gums
What is GERD?
· Backward flow of gastric contents into esophagus = heartburn
