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List the main parts of the digestive tract in order:
Mouth, pharynx, esophagus, small intestine, large intestine, and anus.

The digestive tract, extends from the mouth to the anus and is approximately 30 feet long (Figure 45-1). (pg 1437)
What is the prep for a UGI study?
No anticholinergic medications for 24 hours, NPO status after midnight, smoking is prohibited before the test because nicotine stimulates the flow of gastric secretions.
What nursing measures should be implemented when the paitent is placed on TPN?
Blood chemistries should be monitored frequently. Blood glucose should be checked several times each day. (pg 658)
Explain peritonitis and what could be the cause:
Inflammation of the abdominal peritoneum. This condition occurs after fecal matter seeps from the rupture site, causing bacterial contamination of the peritoneal cavity. Some examples may be diverticular abscess and rupture, acute appendicitis with rupture, and strangulated hernia. Chemical irritation can also cause peritonitis. Blood, bile, necrotic tissue, pancreatic enzymes, and foreign bodies are examples of these chemical irritants. (pg 1479)
What is the normal value for Globulin?
2.3 to 3.4
List complications following a colonoscophy:
After colonoscopy, the nurse checks for evidence of bowel perforation (abdominal pain, guarding, distention, tenderness, excessive rectal bleeding, or blood clots) and examines stools for gross blood. Assess for hypovolemic shock.(pg.1445)
What precautions should be taken with a patient experiencing appendicitis?
Avoid self-treatment, particularly the use of laxatives and enemas which may cause perforation of the appendix Nothing should be taken by mouth (NPO) to ensure that the stomach is empty in the event that surgery is needed. An ice bag may be applied to the right lower quadrant to decrease the flow of blood to the area and impede the inflammatory process. Heat is never used because it may cause the appendix to rupture
Name the location and function of the pyloric sphincter:
BOTTOM OF STOMACH, BEGINNING OF THE SMALL INTESTINE, (pg 1440) allows food to pass from the stomach into the duodenum
What is the normal value for LDH (lactic dehydrogenase)?
100 to 190 units/ L.
What is peristalsis?
The coordinated, rhythmic, serial contraction of smooth muscle that forces food through the digestive tract, bile through the bile duct, and urine through the ureter. (pg 1437)
What is the prep for an EGD?
The nurse should explain the procedure to the patien, NPO status after midnight, consent form, patient is usually given a preprocedure intravenous sedative such as midazolam (Versed).
Name 2 gastric secretions
Hydrochhoric Acid and Mucin (pg 1440)
Where is bile produced?
In the Liver
What is a Salem Sump Gastric Tube?
Most commonly used for decompression. The tube is a double-lumen tube: one provides an air vent (blue \\\'pitgail\\\') and the other is for removal of gastric contents (pg 589)
What is the normal value for albumin?
3.5 to 5
What does thrush (candidiasis) of the mouth look like?
Pearly, bluish white “milk-curd” membranous lesions on the mucous membranes of the mouth, tongue, and larynx. (pg 1446)
Explain the action of histamine receptor antagonists:
Histamine H2 receptor blockers: decrease acid secretions by blocking the histamine H2 receptors; these include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid). Do not give histamine receptor antagonists within 2 hours of antacids.(pg. 1455)
What is gastrointestinal decompression?
Removal of secretions and gaseous substances from GI tract; prevention or relief of abdominal distention (pg. 1460) Treatment includes the evacuation of intestinal contents by means of an intestinal tube. An NG or nasojejunal tube is inserted and connected to wall suction to decompress the intestine.
What causes Cirrhosis?
Alcoholic cirrhosis is found in patients with a history of chronic ingestion of alcohol Postnecrotic cirrhosis is caused by viral hepatitis, exposure to hepatotoxins or infection Primary biliary cirrhosis is found more often in women and results from destruction of the bile ducts Secondary biliary cirrhosis is caused by chronic biliary tree obstruction caused by gallstones, a tumor, or biliary atresia in children Cardiac cirrhosis results from long-standing, severe right-sided heart failure in patients with cor pulmonale, constrictive pericarditis, and tricuspid insufficiency
What is the normal lab value for Gamma GT (gamma glutamyltransferase)?
8 to 38 units/L for males or females older than 45 5 to 27 units/L for females younger than 45
When giving antacids with other medications, how do we plan our med pass?
Do not give antacid simultaneously with other medications because absorption of the other medication may be affected; best to separate administration by 2 hours.(pg 1458)
What is the potential complicatin following a barium enema?
Impaction, constipation (pg. 1444)
What is exactly halfway between the umbilicus and the crest of the right ileum?
McBurney\\\'s point
What is the normal value for Albumin Globulin?
1.2 to 2.2
What is Cirrhosis?
Cirrhosis is a chronic, degenerative disease of the liver in which the lobes are covered with fibrous tissue, the parenchyma degenerates, and the lobules are infiltrated with fat. The fibrous (scar) tissue restricts the flow of blood to the organ, which contributes to its destruction. Hepatomegaly (enlargement of the liver) and, later, liver contraction cause loss of the organ\\\'s function.
How do we accurately assess our patients ascitis daily?
Measuring abdominal girth
Explain what happens when we give morphine to patient suffering from acute pancreatitis:
Morphine may cause spasms of the sphincter of Oddi.
What are the signs and symptoms of the patient needing gastrointestinal decompression?
Nausea, inability to pass flatus, spasms of cramping ABD pain, ABD distention,vomiting, signs of dehydration caused by the fluid shift, abdominal tenderness and muscle guarding, and decreased blood pressure.
What is the procedure for an ultrasound of the gallbladder?
The patient is NPO from midnight. If the patient has had recent barium contrast studies, the nurse should request an order for cathartics. Ultrasound cannot penetrate barium, and the study will not be adequate.
Meds used in patients with digestive system alterations include:
What is a colonoscopy?
Examination of the colon from anus to cecum. Therefore, with colonoscopy, the detection of lesions in the proximal colon—which would otherwise be undetected by sigmoidoscopy—is possible. Benign and malignant neoplasms, mucosal inflammation or ulceration, and sites of active hemorrhage can also be visualized. Biopsy specimens can be obtained and small tumors removed through the scope with the use of cableactivated instruments. Actively bleeding vessels can be coagulated.(pg 1444)
What blood studies assess liver function?
List complications following a sigmoidoscopy (lower GI endoscopy)?
After the examination, the nurse observes the patient for evidence of bowel perforation (abdominal pain, tenderness, distention, and bleeding).
Explain the care of a patient with Hepatitis:
Ensuring rest, maintaining adequate nutrition, providing adequate fluids, and caring for the skin. Preventing the transmission of the disease, Proper personal hygiene and good sanitation, patients should be instructed in the proper handling of their own secretions and body wastes and in thorough methods of handwashing. Gown and gloves should be worn when handling excreta, giving enemas, taking rectal temperatures, handling food wastes, handling needles, disposing of urine, or carrying out any other procedure or hygiene measure that involves direct contact with the patient\\\'s body fluids. Use enteric precautions for 7 days after onset of hepatitis A. Use standard precautions for all patients.
Explain what a Esophagogastroduodenoscopy (EGD) is:
EGD is a diagnostic endoscopic procedure that visualizes the upper part of the gastrointestinal tract up to the duodenum. The esophagus, stomach, and duodenum are examined for tumors, varices, mucosal inflammations, hiatal hernias, polyps, ulcers, presence of Helicobacter pylori, strictures, and obstructions. Also, the endoscopist can remove polyps, coagulate sources of active GI bleeding, and perform sclerotherapy of esophageal varices through endoscopy. Areas of narrowing can be dilated by the endoscope itself or by passing a dilator through the scope. Camera equipment may be attached to the viewing lens, and the existing pathologic condition can be photographed. The endoscope can also be used in obtaining tissue specimens for biopsy or culture to determine presence of H. pylori.
What is the prep for a colonoscopy?
Consent form, clear liquid diet is permitted 1 to 3 days before the procedure to decrease the residue in the bowel, NPO status is maintained for 8 hours before the procedure. The nurse administers a cathartic, enemas, and premedication as ordered to decrease the residue in the bowel. A preprocedure IV sedative such as midazolam is often given.(pg 1444-1445)
List the 3 types of herania and their severity:
REDUCIBLE (can be returned to its original position by manipulation) IRREDUCIBLE (or incarcerated: cannot be returned to its body cavity). When the hernia is irreducible or incarcerated, the intestinal flow may be obstructed. STRANGULATED when the blood supply and intestinal flow are occluded. Immediate surgical intervention is performed when a hernia strangulates, to prevent anaerobic infection in this affected area.(pg 1479)
What is the normal value for AST (aspartate aminotransferase):
0 to 35 units/L.
Explain the action of proton pump inhibitors:
Proton pump inhibitor: antisecretory agent to inhibit secretion of gastrin by the parietal cells of the stomach; this includes omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix), and esomeprazole (Nexium).
What is the normal value for total protein?
6.4 to 8.3
How long do you listen to bowel sounds before you chart absence of bowel sounds?
Because peristaltic sounds may be highly irregular, listening for at least 5 minutes is essential before concluding that no bowel sounds are present.(pg. 75)
What testing is done for appendicitis?
A WBC count with differential will be ordered. An abdominal CT scan is helpful for diagnosis. When diagnosis is difficult, Hypaque contrast studies, ultrasound, and laparoscopy may be used.
List complications following a endoscopy:
The nurse should assess for any signs and symptoms of perforation, including abdominal pain and tenderness, guarding, oral bleeding, melena, and hypovolemic shock.(pg. 1443)
List nursing measures to follow after a barium enema:
After the BE study, the patient should be assessed for complete evacuation of the barium. Retained barium may cause a hardened impaction. Stool will be light colored until all the barium has been expelled.(pg. 1444)
What are the S/S of appendicitis?
The patient will often be lying on the back or side with knees flexed in an attempt to decrease muscular strain on the abdominal wall. Constant pain in the right lower quadrant of the abdomen around McBurney\\\'s point, nausea, vomiting, a low-grade fever (99° to 102° F), an elevated white blood cell (WBC) count, rebound tenderness, a rigid abdomen, and decreased or absent bowel sounds.
Explain the action of antacids:
Antacids: neutralize or reduce the acidity of the stomach contents; these are Maalox, Gaviscon, Rolaids, Tums, Mylanta, and Riopan.(pg 1435)
What is Hepatitis B?
Hepatitis B (HBV), or serum hepatitis is transmitted by contaminated serum via blood transfusion, the use of contaminated needles and instruments, needlesticks, illicit IV drug use, and dialysis, and by direct contact with body fluids from infected people, such as breast milk and sexual contact. An ever-increasing risk comes from improper disposal of used needles and syringes. Sharing toothbrushes, razor blades, or personal items with an infected person may also lead to exposure.
Explain bloody stools, where is the bleeding most likely occuring and what will we see?
Black, tarry color is usually upper GI whereas bright red most likely lower GI
What is the action of stool softeners:
Fecal softeners soften stool by lowering the surface tension, which allows the fecal mass to be softened by intestinal fluids. They also inhibit fluid and electrolyte reabsorption by the intestine.(pharm book pg 308) Docusate (colace)
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