Anatomy and Physiology of the Digestive Tract Mouth Where teeth, tongue, and salivary glands begin food digestion Pharynx Muscular structure shared by the digestive and respiratory tracts It joins the mouth and nasal passages to the esophagus Esophagus Long muscular tube that passes through the diaphragm into the stomach Stomach Churns and mixes food with gastric secretions until a semiliquid mass called chyme
Anatomy and Physiology of the Digestive Tract Small intestine Chemical digestion and absorption of nutrients take place Approximately 20 feet long and consists of three sections: the duodenum, the jejunum, and the ileum Liver and pancreatic secretions enter the digestive tract in the duodenum
Anatomy and Physiology of the Digestive Tract Large intestine and anus The first section of the large intestine is the cecum Ascending colon goes up right side of the abdomen Transverse colon crosses abdomen just below waist Descending colon goes down left side of abdomen The last 6 to 8 inches of the large intestine is the rectum, which ends at the anus, where wastes leave the body
Age-Related Changes Teeth are mechanically worn down with age The jaw may be affected by osteoarthritis A significant loss of taste buds with age Xerostomia (dry mouth) is common Walls of esophagus and stomach thin with aging, and secretions lessen Production of hydrochloric acid and digestive enzymes decreases Gastric motor activity slows Movement of contents through the colon is slower Anal sphincter tone and strength decrease
Nursing Assessment and Health History ?? Common complaints of GI system Why is past medical history important?? What family history might be relevant?? What are some common questions you need to ask in your review of systems???
Diagnostic Tests & Procedures Gastrointestinal System
Stool Specimens O&P OB Fecal Fat C & S
RADIOGRAPHIC TESTS Most common tests: 1) Barium swallow or UGI 2) Small Bowel series 3) Barium enema Others: CTS,US abd. X-rays
Total Parenteral Nutrition – (TPN) Nutritionally complete Used when GI system not functioning Short or long term
Figu re 38-9
Critical Thinking Exercise A 71 y.o. woman who underwent a bowel resection for the removal of a tumor is receiving TPN through a central venous catheter. The patient’s fingerstick blood glucose is 250 mg/dl, and the patient’s temp is 102 F and the nurse notes puralent drainage at the catheter insertion site.
Pre-Op Nursing Interventions For GI surgery patients
GI tract cleansing Assess vital signs Liquids for 24 hrs. or NPO IV Antibiotics NGT insertion
Post-Op Nursing Interventions For GI surgery patients
Medical Anorexia Loss of Appetite Caused by: Nausea, decreased sense of taste or smell, mouth disorders, and medications Emotional problems such as anxiety, depression, or disturbing thoughts
Anorexia Medical diagnosis Physician assesses for malnutrition Weight may be monitored over several weeks Complete history and physical examination Serum hemoglobin, iron, total iron-binding capacity, transferrin, calcium, folate, B 12, zinc Thyroid function tests
Anorexia Assessment Record chronic and recent illnesses, hospitalizations, medications, and allergies Female patient’s obstetric history Symptoms: pain, nausea, dyspnea, extreme fatigue The functional assessment reveals patterns of activity and rest, usual dietary patterns, current stressors, and coping strategies—all can affect appetite
Anorexia Interventions Assist with oral hygiene before and after meals Teach proper oral hygiene; refer for dental care Relieve nausea before presenting a meal tray Before serving meal tray, remove bedpans/emesis basins from sight, conceal drains and drainage collection devices, deodorize room if necessary Socialization during mealtime Respect food likes and dislikes Position patient comfortably with easy access to food
Obesity 20% over ideal body wt. Morbid obesity= 2X normal body wt.
Complications CV disease Diabetes Respiratory difficulties Musculoskeletal problems Emotional and social isolation
Treatment Sprue diet and drug therapy, avoid foods w/ gluten(wheat, barley, oats) Lactase avoid milk products & take lactase enzyme ( Lactaid)
Critical Thinking Question A nurse enters the room of a 72-year-old patient who is receiving a continuous tube feeding and finds the patient lying flat in bed. The nurse questions the nurse assistant and discovers that the patient requested to be placed flat. What is significant about this situation? Why? How should the nurse handle the situation?
THAT’S IT…!! YOUR DONE WITH GI UNIT 1 ON TO UNIT 2…..