Presentation is loading. Please wait.

Presentation is loading. Please wait.

Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing.

Similar presentations


Presentation on theme: "Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing."— Presentation transcript:

1 Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing Assistants Chapter 31 - The Digestive System

2 Slide 2 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Structure of the Digestive System

3 Slide 3 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The digestive system is a long tube, or tract, consisting of the: Mouth Pharynx Esophagus Stomach Small intestine Large intestine Structure of the Digestive System

4 Slide 4 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Accessory organs assist in the process of breaking down food: Teeth Tongue Salivary glands Liver Gallbladder Pancreas Structure of the Digestive System

5 Slide 5 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Structure of the Digestive System

6 Slide 6 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The walls of the tube that forms the digestive tract are made up of four layers of tissue: The mucosa The submucosa The muscle layer, and The serosa The Digestive Tract

7 Slide 7 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The mucosa, a mucous membrane, lines the digestive tract The mucosa helps to Trap disease-causing microbes Protect the delicate tissues of the digestive tract from stomach acid, a very harsh fluid produced by the stomach to help digest food The Digestive Tract: The Mucosa

8 Slide 8 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The submucosa contains blood vessels and nerves The Digestive Tract: The Submucosa

9 Slide 9 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The muscle layer contains smooth muscle Peristalsis action of the muscle layer (contraction of the smooth muscle in the walls of the digestive tract) moves food through the system The Digestive Tract: The Muscle Layer

10 Slide 10 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The serosa is a tough outer layer of connective tissue The Digestive Tract: The Serosa

11 Slide 11 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The Mouth Food begins its journey through the digestive tract at the mouth, or oral cavity The mouth is lined with a mucous membrane and houses the teeth and tongue, accessory organs that assist with chewing and swallowing food The Mouth, Pharynx, and Esophagus

12 Slide 12 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The Pharynx From the mouth, food moves into the pharynx (throat) The Mouth, Pharynx, and Esophagus

13 Slide 13 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The Esophagus The esophagus is a long narrow tube that serves mainly as a passageway for food to get from the pharynx to the stomach After entering the abdominal cavity, the esophagus connects with the upper part of the stomach The mucus secreted by the esophageal mucosa, as well as the action of the muscle layer, helps to move food downward and into the stomach The Mouth, Pharynx, and Esophagus

14 Slide 14 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The stomach is a hollow, muscular holding pouch for food The stomach has three main regions: The fundus The body The pylorus The Stomach

15 Slide 15 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The fundus is the upper region The Stomach: The Fundus

16 Slide 16 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The body is the main region The esophagus enters the stomach here The esophageal (cardiac) sphincter, a circle of muscular tissue, surrounds the place where the esophagus enters the stomach and keeps food from going back up the esophagus after it has entered the stomach The Stomach: The Body

17 Slide 17 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The pylorus is the bottom region Food leaves the stomach through the pyloric sphincter, a circle of muscular tissue that surrounds the place where the stomach empties into the small intestine The pyloric sphincter helps to prevent food from returning to the stomach once it enters the small intestine The Stomach: The Pylorus

18 Slide 18 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Folds of the mucosa, called rugae, flatten out as food enters the stomach, almost doubling the stomachs holding capacity The Stomach: Rugae

19 Slide 19 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The small intestine, which is about 20 feet long, is so named because its diameter is much smaller than that of the large intestine The small intestine has three regions, called the duodenum, the jejunum, and the ileum The Small Intestine

20 Slide 20 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The large intestine (also called the colon) is 4 1/2 feet long and is much larger in diameter than the small intestine The large intestine has several distinct regions: The cecum The ascending colon The transverse colon The descending colon The sigmoid colon The rectum The appendix The Large Intestine

21 Slide 21 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The cecum is like a waiting room for food that is leaving the small intestine through the ileocecal valve and entering the large intestine Food moves through the large intestine much more slowly than it moves through the small intestine Therefore, incoming deliveries from the small intestine need a place to wait until the next segment of the large intestine, the ascending colon, is able to accept more food for processing The Large Intestine: The Cecum

22 Slide 22 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The ascending colon travels upward from the cecum The Large Intestine: The Ascending Colon

23 Slide 23 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The transverse colon travels across The Large Intestine: The Transverse Colon

24 Slide 24 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The descending colon travels down The Large Intestine: The Descending Colon

25 Slide 25 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The sigmoid colon is an S-shaped curve at the end of the descending colon The Large Intestine: The Sigmoid Colon

26 Slide 26 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The rectum is the last segment of the colon The place where the rectum opens to the outside of the body is the anus The Large Intestine: The Rectum

27 Slide 27 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The appendix, a tiny, closed pouch that dangles from the cecum, has no known function The appendix has a way of making its presence known Inflammation or infection of the appendix causes appendicitis, a painful condition that is life-threatening if not treated Treatment is surgical removal of the appendix The Large Intestine: The Appendix

28 Slide 28 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Several organs that play a role in digestion but are not actually part of the digestive tract are called accessory organs Salivary glands Liver Gallbladder Pancreas The Accessory Organs

29 Slide 29 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The salivary glands are located near the mouth They produce and secrete saliva, a substance that helps with chewing and swallowing by moistening the food The Accessory Organs: Salivary Glands

30 Slide 30 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The liver is a large organ located just underneath the diaphragm The liver produces and secretes bile into the duodenum Bile is a substance that helps with the digestion of fats The liver also has several other important functions that are not related to digestion. For example The liver produces clotting factors (chemicals that help our blood to clot) The liver helps to clear our blood of toxins, such as alcohol and drugs The Accessory Organs: The Liver

31 Slide 31 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The gallbladder, a small pouch that is attached to the liver, stores bile produced by the liver that is not secreted directly into the duodenum The Accessory Organs: The Gallbladder

32 Slide 32 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The pancreas is located behind the stomach, in the curve of the duodenum The pancreas produces substances that aid in digestion and secretes them into the duodenum The pancreas also produces insulin and glucagon, hormones that are secreted directly into the bloodstream The Accessory Organs: The Pancreas

33 Slide 33 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Function of the Digestive System

34 Slide 34 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The digestive system breaks down the food we eat into nutrients, which are then absorbed into the bloodstream for use by the bodys cells In addition, the digestive system removes unusable digested food from the body, in the form of feces So…the digestive system performs the following functions: Digestion Absorption Excretion Function of the Digestive System

35 Slide 35 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Digestion: the breaking down of food into simple elements (nutrients) Mechanical digestion: breaking down by physical means, such as chewing Chemical digestion: breaking down by chemical means, such as enzymes Digestion begins in the mouth and continues in the stomach and small intestine Function of the Digestive System: Digestion

36 Slide 36 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. After passing through the esophagus, the food we eat stays in the stomach for 3 to 4 hours, where digestion continues to take place Special glands in the stomach lining produce hydrochloric acid (sometimes called stomach acid) and enzymes The stomach acid and enzymes act on the pieces of food to break them down even further The peristaltic action of the stomach helps to mix the food with the acid and enzymes, creating a liquid substance called chyme Function of the Digestive System: Digestion

37 Slide 37 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The chyme passes into the duodenum, the first segment of the small intestine Once in the duodenum, the chyme mixes with bile (secreted by the liver) and digestive enzymes secreted by the pancreas These substances cause further breakdown of the food From the duodenum, the chyme passes into the jejunum Function of the Digestive System: Digestion

38 Slide 38 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Once the chyme reaches the jejunum, absorption of nutrients begins At this point, the food is fairly well-digested Now, it is time to start moving the nutrients from the digestive tract into the bloodstream To reach the bloodstream, the nutrients pass through the mucosa and into the blood vessels in the next layer, the submucosa Function of the Digestive System: Absorption

39 Slide 39 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The mucosa of the small intestine has millions of tiny finger-like structures called villi The villi increase the small intestines ability to absorb nutrients by increasing the surface area of the mucosa Function of the Digestive System: Absorption

40 Slide 40 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Although most of the absorption of nutrients takes place in the small intestine, the large intestine also plays a role in absorption Bacteria that live in the large intestine act on the chyme to produce vitamin K and some B vitamins, which are absorbed by the body Function of the Digestive System: Absorption

41 Slide 41 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The action of these bacteria on the chyme can also produce gas as a by-product, especially when high-fiber foods such as beans, onions, and broccoli are part of the diet As the chyme passes slowly through the large intestine, water is absorbed into the bloodstream By the time the chyme reaches the end of the long intestine, all nutrients and most of the water have been removed, and the chyme has taken on the soft, moist, semi-solid consistency of normal feces Function of the Digestive System: Absorption

42 Slide 42 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The feces (waste products of digestion) collect in the rectum, the last segment of the large intestine The walls of the rectum gradually expand as the feces build up At a certain point, the brain senses that the rectum is full and the urge to defecate (have a bowel movement) occurs Function of the Digestive System: Excretion

43 Slide 43 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Effects of Aging on the Digestive System

44 Slide 44 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Like all of the bodys organ systems, the digestive system is affected by the process of aging: Less efficient chewing and swallowing Less efficient digestion Increased risk for constipation Effects of Aging on the Digestive System

45 Slide 45 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Less efficient chewing and swallowing In older people, the production of saliva decreases, which may make chewing and swallowing more difficult Missing or painful teeth or poorly fitting dentures may cause the older person to choke as a result of trying to swallow food that has not been chewed properly Effects of Aging on the Digestive System

46 Slide 46 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Remember that when you are helping an older person to eat you must Create a relaxed, social environment for eating and help the person to cut food up into small, easy-to-chew pieces Report complaints of poorly fitting dentures, sores in the mouth or on the tongue, or a toothache to the nurse immediately Effects of Aging on the Digestive System

47 Slide 47 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Less efficient digestion In an older person, the production of saliva, stomach acid, and digestive enzymes slows, making chemical digestion less efficient Digestion is less efficient because not only are fewer chemicals available for chemical digestion, but the pieces of food that the chemicals must work on may be larger, due to inefficient chewing Effects of Aging on the Digestive System

48 Slide 48 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Increased risk for constipation In an older person, the movement of food through the digestive tract may be slower The chyme spends more time in the large intestine, which allows more water to be reabsorbed into the bloodstream As a result, by the time the chyme reaches the end of the large intestine, almost all of the water has been removed and the resulting feces are hard, dry, and difficult to pass Effects of Aging on the Digestive System

49 Slide 49 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Disorders of the Digestive System

50 Slide 50 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Many of the people you will care for will have a digestive disorder of some sort, or will be recovering from one Because the digestive system contains so many different organs, there are many different disorders that can occur Four of the most common digestive disorders that you are likely to see in the health care setting are Ulcers Hernias Gallbladder disorders Cancer Disorders of the Digestive System

51 Slide 51 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Ulcers Sores caused by wearing away of the protective mucosa that lines the digestive tract Can occur anywhere along the digestive tract The most common sites are the stomach (gastric ulcer) and the duodenum (duodenal ulcer) In severe cases, the ulcer may affect all of the layers of the stomach or duodenum wall, not just the mucosa, causing a penetrating ulcer. This is a life-threatening condition. Disorders of the Digestive System: Ulcers

52 Slide 52 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Causes of Ulcers Ulcers occur when the stomach produces too much hydrochloric acid Factors such as smoking, frequent use of over-the-counter pain drugs, and infection with a bacterium called Helicobacter pylori can increase a persons chances of developing ulcers Disorders of the Digestive System: Ulcers

53 Slide 53 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Symptoms A person with an ulcer may feel uncomfortably full or nauseous after eating Stomach pain is common, especially within 3 hours of eating (or when the person does not eat) Most ulcers are chronic and the person will have periods of feeling well, interrupted by flare-ups of symptoms Treatment Most ulcers can be treated with medication People with severe ulcers may need surgery Disorders of the Digestive System: Ulcers

54 Slide 54 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Hernias The abdominal cavity (the space in the body where most of the digestive organs are found) is bounded by muscular walls A hernia occurs when an internal organ bulges through a weakness in the muscular wall of the abdominal cavity Disorders of the Digestive System: Hernia

55 Slide 55 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Sometimes the weakness occurs at the site of an old surgical incision Other times, the muscle is just weak in spots If there is a weak spot in the muscular wall, and the person does something that requires a lot of physical effort (such as lifting a heavy object), a hernia may occur Disorders of the Digestive System: Hernia

56 Slide 56 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Inguinal hernias and femoral hernias Inguinal hernias and femoral hernias occur when a loop of intestine bulges through the abdominal wall in the groin area Inguinal hernias are more common in men, and femoral hernias are more common in women These types of hernias are repaired surgically Umbilical hernias Umbilical hernias occur around the naval (belly button) If the umbilical hernia is very small, no treatment may be needed However, surgery may be required to repair a larger umbilical hernia Disorders of the Digestive System: Hernia

57 Slide 57 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Hiatal hernias Part of the stomach passes through the hiatus, the opening in the diaphragm that allows the esophagus to pass into the abdominal cavity People with hiatal hernias often have heartburn because the stomach acid moves back up into the esophagus Eating small, frequent meals and sitting up for at least 2 hours after every meal helps to relieve the heartburn Medication can also provide relief of symptoms People with severe symptoms may need surgery to repair the hernia Disorders of the Digestive System: Hernia

58 Slide 58 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Strangulated hernia Complications occur if the muscle tightens around the trapped tissue, cutting off its blood supply This situation is a surgical emergency Disorders of the Digestive System: Hernia

59 Slide 59 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Gallstones can form and block the flow of bile from the gallbladder into the duodenum This can lead to inflammation and infection of the gallbladder Disorders of the Digestive System: Gallbladder Disorders

60 Slide 60 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Symptoms Episodes of severe pain that may stay in the upper abdominal region, or radiate to the back and shoulder on the persons right side Indigestion, especially after eating foods that are high in fat Pale and clay-colored feces (due to low bile content) Treatment Medication or laser treatment to dissolve the gallstones In some cases, surgical removal of the gallbladder is needed Disorders of the Digestive System: Gallbladder disorders

61 Slide 61 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Cancer Any of the organs in the digestive system can be affected by cancer The persons signs and symptoms will vary, depending on the location of the tumor Disorders of the Digestive System: Cancer

62 Slide 62 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Symptomsmay include: Loss of appetite Indigestion Pain Vomiting Constipation Changes in bowel movements Blood in the stool Treatment Surgery, radiation, chemotherapy, or a combination of these Disorders of the Digestive System: Cancer

63 Slide 63 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Diagnosis of Digestive Disorders

64 Slide 64 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Digestive complaints such as heartburn, indigestion, nausea, vomiting, stomachache, gas, diarrhea, and constipation are common Often, these symptoms are not a sign of anything more serious than eating too much! However, sometimes they may signal a serious disorder Always report a new symptom, or a change in the persons symptoms, to the nurse immediately Diagnosis of Digestive Disorders

65 Slide 65 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Sometimes, the doctor will order one or more tests to evaluate a persons symptoms Some of these tests are simple, such as laboratory analysis of a stool sample Others are more involved, such as: Endoscopy Imaging studies x-rays computed tomography (CT) scans magnetic resonance imaging (MRI) scans Diagnosis of Digestive Disorders

66 Slide 66 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Endoscopy Endoscopy involves using a special instrument to look inside the digestive tract and obtain tissue or fluids for analysis Endoscopy allows the doctor to look inside the digestive tract for tumors or other abnormal growths The type of endoscope used depends on whether the instrument will be passed through the persons mouth (to view the upper digestive tract) or anus (to view the lower digestive tract) Diagnosis of Digestive Disorders

67 Slide 67 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Imaging studies, such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans allow the doctor to view the organs of the digestive system without actually entering the body Sometimes, the person is asked to swallow barium or have a barium enema prior to the procedure Barium is a radioactive substance that coats the mucosa of the digestive tract, and makes the organs appear sharper and brighter Diagnosis of Digestive Disorders

68 Slide 68 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. The person may have a special diet in the days leading up to the procedure, or be placed on NPO status Sometimes, an enema is ordered to clean out the large intestine prior to the procedure The nurse will let you know of any special care needs for a person who is having one of these procedures Diagnosis of Digestive Disorders

69 Slide 69 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Caring for a Person with an Ostomy

70 Slide 70 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Done when a segment of the intestine needs to be removed, due to disease or injury Provides the person with an alternate way of eliminating feces from the body following the surgery An artificial opening, called a stoma, is made in the abdominal wall and the remaining portion of the intestine is connected to it Feces pass through the stoma and into a pouch (called an ostomy appliance) that is worn over the stoma An Ostomy

71 Slide 71 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. An ileostomy is created if the entire large intestine must be removed The end of the small intestine (that is, the ileum) is attached to the abdominal wall Because the chyme does not have the chance to travel through the large intestine (where water is reabsorbed), the persons feces are very liquid and may flow fairly continuously For this reason, a person with an ileostomy is quite prone to dehydration An Ostomy: Ileostomy

72 Slide 72 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. A colostomy is created if part of the large intestine is still present After the diseased part of the large intestine is removed, the healthy end is attached to the abdominal wall Among people with colostomies, the feces vary in consistency An Ostomy: Colostomy

73 Slide 73 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Cancer Bowel trauma and diseases such as diverticulitis (an inflammatory disease of the bowel) Sometimes, a temporary ostomy is done to allow a portion of the bowel to rest. Later, the ends of the bowel are sewn back together and normal bowel elimination resumes. Reasons for a Person to have an Ostomy

74 Slide 74 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. For many people, having an ostomy is very difficult, emotionally First, the person must cope with having an illness or injury serious enough to require major surgery Secondly, many people consider elimination, especially bowel elimination, a very private activity Having to wear a bag to collect feces on the outside of the body is very embarrassing for many people Especially in the beginning, it may be very hard for a person to accept the ostomy Feelings of a Person with an Ostomy

75 Slide 75 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Take the time to listen carefully if the person wants to talk about his fears or uncertainties Be careful not to brush off the persons concerns with a comment such as Oh, everything will be OK now; dont worry. Instead, put yourself in the persons shoes and think about how you would feel if you were in the same situation Report the persons comments and questions to the nurse Once the nurse knows that the person is having trouble adjusting to the ostomy, there are many things he or she can do to help the person adjust Caring for a Person with an Ostomy

76 Slide 76 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. In some states and facilities, helping patients or residents to care for an ostomy is within the scope of the nursing assistant Ostomies can be located in many different places on the abdomen and abdomens vary from person to person Caring for a Person with an Ostomy

77 Slide 77 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Ostomy appliances Some ostomy appliances consist of a bag with an adhesive opening that adheres to the skin around the stoma Other ostomy appliances have two pieces a ring of flexible rubber that is applied to the skin around the stoma, and a bag that is snapped on to the ring Some appliances are used only once and then discarded, while others are emptied, cleaned, and used again Caring for a Person with an Ostomy

78 Slide 78 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Principles of ostomy care Are the same for every patient or resident with an ostomy Because the skin around the ostomy comes into contact with feces, it must be kept clean to prevent irritation The ostomy appliance can be changed with the person sitting or standing in the bathroom, or while the person is in bed If the ostomy appliance is being changed while the person is in bed, the person should either sit upright or lie flat Caring for a Person with an Ostomy

79 Slide 79 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. End of Presentation


Download ppt "Slide 1 Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing Assistants. Textbook For Nursing."

Similar presentations


Ads by Google