digestive and gi

Ultrasonography nursing intervention

-fast for 8-12 hours before test -fat free diet in gallstones assess LOC, orientation, and ability to ambulate if sedated

inspection

-noting skin changes, nodules, lesions, scarring, discolorations, inflammation, bruising, or striae -contour and symmetry of abd. -bulging, distention, or peristaltic waves id

auscultation

-used to determine the character, location, and frequency of abs. -always performed before percussion and palpation

A nurse assesses the abdomen of a newly admitted client. Which finding would necessitate further investigation?

Asymmetrical upper quadrants

nursing intervention -Upper GI Tract

Before test- clear liquid diet -NPO midnight before test -bowel cleansing prep. no smoking, chewing gum, and using mints (stimulate gastric motility)

serum lab studies

CBC complete metabolic panel carcinoembryoic antigen ( Cancer)

When gastric analysis testing reveals excess secretion of gastric acid, which of the following medical diagnoses is supported?

Duodenal ulcer

If the pancreas was functioning correctly, where would the bile and pancreatic enzymes enter the GI system?

Duodenum

The nurse is investigating a patient's complaint of pain in the duodenal area. Where should the nurse perform the assessment

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

Gastrin has which of the following effects on gastrointestinal (GI) motility?

Increased motility of the stomach

A patient asks the nurse why the physician ordered the blood test carcinoembryonic antigen (CEA). The nurse answers:

It indicates if a cancer is present.

opening between the stomach and duodenum?

Pyloric sphincter

The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass. The nurse is most correct to state at which location?

Sigmoid colon

The nurse is preparing to examine the abdomen of a client complaining of a change in his bowel pattern. The nurse would place the client in which position?

Supine with knees flexed

pepsin

a gastric enzyme that is important in protein digestion

intrinsic factor

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

achalasia

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

hydrochloric acid

acid secreted by the glands in the stomach; mixes with chime 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

(parts of) large intestine

ascending segment transverse segment descending segment sigmoid colon rectum

percussion

assess the size and density of the abdominal organs and to detect the presence of air-filled, fluid-filled, or solid masses

lower G.I. Tract

begins at the ileum and ends at the anus

upper G.I Tract

begins at the mouth and ends at the jejunum

function

breakdown of food particles absorption into the bloodstream of small nutrients elimination of undigested unabsorbed foodstuffs and other waste products

esophagus

collapsible tube connecting the mouth to the stomach, through which food passes as it is igested

diagnostic evaluation

confirm, rule out, stage, or diagnose various disease states

abdominal ultrasonography

detection of enlarged gallbladder or pancreas, the presence of gallstones, an enlarged ovary, an ectopic pregnancy, or appendicitis, acute colonic diverticulitis

breath tests

developed to evaluate CHO absorption, dx bacterial overgrowth in intestines, and short vowel syndrome

digestion

digestive enzymes and secretions mix with ingested food and when proteins, fats, and sugars are broken down into their component smaller molecules

stomach

distensible pouch into which the food bolus passes into the bloodstream

trypsin

enzyme that aids in the digestion of protein

The nurse is caring for a patient who complains of abdominal bloating, distention, and feeling full of gas. These could be symptoms of which of the following?

food allergy

pepsin (location)

gastric mucosa

norepinephrine

generally inhibitory (effect on secretion) decreased motility/ increase sphincter tone stimulated by stress, other carious stimuli

One or two bowel sounds in 2 minutes would be documented as which of the following?

hypoactive

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test?

increase fluid intake

gastrin

increase secretion of gastric juice increase motility of stomach stimulated by stomach distention with food

acetylcholine

increased gastric acid increase motility/decrease sphincter tone stimulated by sight, smell, chewing food, stomach distention

histamine

increased gastric acid production stimulated by substance in food

dyspepsia

indigestion, upper abd. discomfort associated with eating

secretin

inhibits gastic secretion slows gastric emptying stimulated by pH of chime (duodenum) below 4-5

cholecystokinin

inhibits gastric secretion stimulated by fat in duodenum

stool test

inspecting the specimen for consistency, color, and occult blood (diet/ med restriction)

When examining the abdomen of a client with complaints of nausea and vomiting, which of the following would the nurse do first?

inspection

trypsin (location)

intestinal mucosa

fibroscopy

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

anus

last section of GI tract; outlet for waste products

A nurse is teaching a client what to expect following a barium enema. Which client statement indicates a need for further teaching?

limit my fiber intake for 1 to 2 weeks

villi

lines intestine produces digestive enzymes as well as absorb nutrients.

After 20 seconds of auscultating for bowel sounds on a client recovering from abdominal surgery, the nurse hears nothing. Which of the following should the nurse do based on the assessment findings?

listen longer

While palpating a client's right upper quadrant (RUQ), the nurse would expect to find which structure?

liver

small intestine

longest portion of GI tract through which food mixed in all secretions and enzymes passes as it continues to be digested and begins to be absorbed into the bloodstream

chime

mixture of food with saliva, salivary enzymes, and gastric secretions that is produced as food passes through the mouth, esophagus, and stomach

anatomy of GI tract

mouth esophagus stomach small/large intestine rectum anus

physical assessment

oral cavity inspection and palpation abdominal inspection, auscultation , percussion, and palpation rectal inspection and palpation

health history

pain dyspepsia (indigestion) gas N/v change in bowel habits past health, family and social history

amylase (location)

pancreas and intestinal mucosa

Which of the following is an enzyme secreted by the gastric mucosa?

pepsin

elimination

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

ingestion

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

absorption

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

large intestine

portion where waste material passes from small intestine passes as absorption continues and elimination begins.

segmentation contractions

produce mixing waves that move the intestinal contents back and forth in a churning motion

intestinal peristalsis

propels the contents of the small intestine toward the colon

A nurse is providing post procedure instructions for a client who had an esophagogastroduodenoscopy. The nurse should perform which action?

review information with person accompanying pt. home.

ptyalin (location)

salivary glands

(parts of ) small intestine

stomach

The nurse has been directed to position a patient for an examination of the abdomen. What position should the nurse place the patient in for the examination?

supine position

palpation

used to identify areas of tenderness or muscular resistance (light) and to identify large masses (deep)

trypsin (pancreas)

which aids in digesting protein

amylase

which aids in digesting starch

imaging studies

x-ray contrast studies computed tomography (CT) magnetic resonance imaging (MRI) Positron emission tomography (PET) scintigraphy