Chapter 43: Assessment of Digestive and Gastrointestinal Function

Intrinsic factor is a gastric secretion necessary for the intestinal absorption of vitamin _________, which prevents pernicious anemia.

B12

A patient reports abdominal pain associated with indigestion. What is characteristic of this type of pain? a. described as crampy or burning b. in the left lower quadrant c. less severe after an intake of fatty foods d. relieved by the intake of coarse vegetables, which stimulates peristalsis

a. described as crampy or burning

The nurse is investigating a patient's report of pain in the duodenal area. Where should the nurse perform the assessment? a. epigastric area and consider possible radiation of pain to the right subscapular region b. hypogastrium in the right or left lower quadrant c. left lower quadrant d. periumbilical area, followed by the right lower quadrant

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

The nurse is assisting the healthcare provider with a gastric acid stimulation test for a patient. What medication should the nurse prepare to administer subcutaneously to stimulate gastric secretions? a. pentagastrin b. atropine c. glycopyrrolate d. acetylcysteine

a. pentagastrin

The nurse is providing instructions to a patient scheduled for a gastroscopy. What should the nurse be sure to include in the instructions? Select all that apply. a. the patient must fast for 8 hours before the exam b. the throat will be sprayed with a local anesthetic c. after gastroscopy, the patient cannot eat or drink until the gag reflex returns (1 to 2 hours) d. the healthcare provider will be able to determine if there is a presence of bowel disease e. the patient must have bowel cleansing prior to the procedure

a. the patient must fast for 8 hours before the exam b. the throat will be sprayed with a local anesthetic c. after gastroscopy, the patient cannot eat or drink until the gag reflex returns (1 to 2 hours)

Facilitates the production of dextrins and maltose

amylase

During a colonoscopy with moderate sedation, the patient groans with obvious discomfort and begins bleeding from the rectum. The patient is diaphoretic and has an increase in abdominal girth from distention. What complication of this procedure is the nurse aware may be occurring? a. infection b. bowel perforation c. colonic polyp d. rectal fissure

b. bowel perforation

A patient is scheduled for a fiberoptic colonoscopy. What does the nurse tell the patient fiberoptic colonoscopy is most frequently used to diagnose? a. bowel disease of unknown origin b. cancer screening c. inflammatory bowel disease d. occult bleeding

b. cancer screening

The nurse is performing an assessment of a patient. During the assessment the patient informs the nurse of some recent "stomach trouble." What does the nurse recognize is the most common symptom of patients with GI dysfunction? a. diffuse pain b. dyspepsia c. constipation d. abdominal bloating

b. dyspepsia

Secreted by the gallbladder, responsible for fat emulsification

bile

A patient is being prepared for esophageal manometry. The nurse should inform the patient to withhold what medication for 48 hours prior to the procedure? a. amiodarone b. calan c. aspirin d. metoprolol

c. aspirin

The nurse auscultates a patient's abdomen to assess bowel sounds, documenting five to six sounds heard in less than 30 seconds. How does the nurse document the character of the bowel sounds? a. normal b. hypoactive c. hyperactive d. borborygmi

c. hyperactive

The nurse is performing an initial assessment of a patient reporting increased stomach acid related to stress. The nurse knows that the healthcare provider will want to consider the influence of what neuroregulator? a. gastrin b. cholecystokinin c. norepinephrine d. secretin

c. norepinephrine

pH of stomach

1.0

It takes ____ hours after eating for food to pass into the terminal ileum. It take ____ hours for food to reach and distend the rectum.

4; 12

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? a. prone position with pillows positioned to alleviate pressure on the abdomen b. semi-fowler position with the left leg bent to minimize pressure on the abdomen c. supine position with the knees flexed to relax the abdominal muscles d. reverse Trendelenburg position to facilitate the natural propulsion of intestinal contents

c. supine position with the knees flexed to relax the abdominal muscles

The nurse is collecting a stool specimen from a patient. What characteristic of the stool indicates to the nurse that the patient may have an upper GI bleed? a. clay colored b. greasy and foamy c. tarry and black d. threaded with mucus

c. tarry and black

Four anatomic regions of the stomach

cardia, fundus, body, pylorus

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

cardiac sphincter

A patient is in the outpatient recovery area after having a colonoscopy and informs the nurse of abdominal cramping. What is the best response by the nurse? a. "We may need to go back in and see what is wrong. You shouldn't have discomfort." b. "I will call the physician and let him know. He may have put too much air in your colon." c. "I will call the physician and see if I can give you pain medication. Sometimes the pain can be caused by having a biopsy." d. "The cramping is caused by the air insufflated in the colon during the procedure."

d. "The cramping is caused by the air insufflated in the colon during the procedure."

The nurse is performing an abdominal assessment for a patient in the hospital with reports of abdominal pain. What part of the assessment should the nurse perform first? a. percussion b. palpation c. auscultation d. inspection

d. inspection

The nurse is assisting the healthcare provider with a colonoscopy for a patient with rectal bleeding. The nurse is asked to administer glucagon during the procedure. Why is the nurse asked to administer this medication during the procedure? a. the patient is probably hypoglycemic and requires the glucagon b. to relieve anxiety during the procedure for moderate sedation c. to reduce air accumulation in the colon d. to relax colonic musculature and reduce spasm

d. to relax colonic musculature and reduce spasm

Structural changes in the esophagus that occur as the result of age related changes

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

major carbohydrate that tissues use for fuel

glucose

helps form galactose

lactase

glucose is a product of this enzyme's action

maltase

digests protein and helps form polypeptides

pepsin

The digestion of starches begins in the mouth with the secretion of ____________.

ptyalin

A hormonal regulatory substance that inhibits its stomach contraction and gastric secretions

secretin

Digests carbohydrates & helps form fructose

sucrase

Helps convert protein into amino acids

trypsin

three pancreatic secretions that contain digestive enzymes

trypsin, amylase, lipase