3Anatomy and Physiology of the Digestive Tract MouthWhere teeth, tongue, and salivary glands begin food digestionPharynxMuscular structure shared by the digestive and respiratory tractsIt joins the mouth and nasal passages to the esophagusEsophagusLong muscular tube that passes through the diaphragm into the stomachStomachChurns and mixes food with gastric secretions until a semiliquid mass called chyme
4Anatomy and Physiology of the Digestive Tract Small intestineChemical digestion and absorption of nutrients take placeApproximately 20 feet long and consists of three sections: the duodenum, the jejunum, and the ileumLiver and pancreatic secretions enter the digestive tract in the duodenum
5Anatomy and Physiology of the Digestive Tract Large intestine and anusThe first section of the large intestine is the cecumAscending colon goes up right side of the abdomenTransverse colon crosses abdomen just below waistDescending colon goes down left side of abdomenThe last 6 to 8 inches of the large intestine is the rectum, which ends at the anus, where wastes leave the body
6Age-Related Changes Teeth are mechanically worn down with age The jaw may be affected by osteoarthritisA significant loss of taste buds with ageXerostomia (dry mouth) is commonWalls of esophagus and stomach thin with aging, and secretions lessenProduction of hydrochloric acid and digestive enzymes decreasesGastric motor activity slowsMovement of contents through the colon is slowerAnal sphincter tone and strength decrease
7Nursing Assessment and Health History ?? Common complaints of GI systemWhy 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???
26Critical 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.
27Pre-Op Nursing Interventions .For GI surgery patients
28GI tract cleansingAssess vital signsLiquids for 24 hrs. or NPOIVAntibioticsNGT insertion
29Post-Op Nursing Interventions For GI surgery patients
30Relieve painDetect complicationsPrevent gastric distentionReplace lost fluidsMaintain urine elimination
32Medical Anorexia Loss of Appetite Caused by: Nausea, decreased sense of taste or smell, mouth disorders, and medicationsEmotional problems such as anxiety, depression, or disturbing thoughts
33Anorexia Medical diagnosis Physician assesses for malnutrition Weight may be monitored over several weeksComplete history and physical examinationSerum hemoglobin, iron, total iron-binding capacity, transferrin, calcium, folate, B12, zincThyroid function tests
34AnorexiaAssessmentRecord chronic and recent illnesses, hospitalizations, medications, and allergiesFemale patient’s obstetric historySymptoms: pain, nausea, dyspnea, extreme fatigueThe functional assessment reveals patterns of activity and rest, usual dietary patterns, current stressors, and coping strategies—all can affect appetite
35Anorexia Interventions Assist with oral hygiene before and after meals Teach proper oral hygiene; refer for dental careRelieve nausea before presenting a meal trayBefore serving meal tray, remove bedpans/emesis basins from sight, conceal drains and drainage collection devices, deodorize room if necessarySocialization during mealtimeRespect food likes and dislikesPosition patient comfortably with easy access to food
36Obesity20% over ideal body wt.Morbid obesity= 2X normal body wt.
37Complications CV disease Diabetes Respiratory difficulties Musculoskeletal problemsEmotional and social isolation
106TreatmentSprue diet and drug therapy, avoid foods w/ gluten(wheat, barley, oats)Lactase avoid milk products & take lactase enzyme ( Lactaid)
107Critical 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?
108THAT’S IT…!!YOUR DONEWITH GI UNIT 1ON TO UNIT 2…..