GI system Part 1单词卡 | Quizlet

Focused GI Assessment Techniques

Inspect, Auscultate, Percuss, Palpate

Inspect Areas for GI Assessment

Oral cavity, abdomen

Auscultation in GI Assessment

Start at RLQ, move clockwise; listen for bowel sounds before palpation; normal 5-30 sounds/min; listen 5 min to confirm absence

Light Palpation Purpose

Feeling for tenderness and tone; start away from discomfort

Age-Related GI Changes/s.s: Esophagus

Changes:Stiffening, decreased peristalsis, decreased gastric emptying

S/s: Chest pain, eructation, heartburn, indigestion, early satiety, OTC GERD treatment, weight loss

Age-Related GI Changes/s.s: Liver

Change: Decreased bile synthesis, widened bile duct, increased cholecystokinin secretion

S/s: RUQ pain,early satiety, decreased appetite; skin inspection, abdominal palpation

Age-Related GI Changes/s.s: Pancreas

Changes: Distention/dilation of ducts, decreased weight, decreased beta cell sensitivity, decreased lipase production

S/s:Diabetes symptoms (thirst, urination, appetite), upper quadrant/right shoulder pain, stool color/consistency, weight loss, serum glucose levels

Age-Related GI Changes/s.s: Hepatic

Change:Decreased hepatic cells, enzyme activity, cholesterol synthesis

S/s:Medication use, alcohol intake; abdominal percussion and palpation

Age-Related GI Changes/s.s: Intestines

Changes: Decreased peristalsis, mucus secretion, elasticity, sensation

S/s: Bowel movement frequency, bloating, urgency, straining, incontinence; bowel sounds, percussion, rectal exam

GI: Laboratory studies

CBC: detect blood loss, inflammation/infection

BMP: electrolytes imbalance due to impaired absorption/excretion

CMP: added albumin(nutritional status) and LFTs

Liver function tests: ALT, AST, Total bilirubin

Stool tests: blood, bacteria, parasites

Gastric fluid: blood, bacteria, medications, acidity

GI: Image studies

ABD x-ray: masses, obstruction, stricture; air=obstruction

ABD US: assess organ + blood vessels, ascites, no tolerate to contrast, cyst/tumor/mass in liver/pancreas, stone in gallbladder/kidney, aneurysm in ABD aorta, intervention(stent placement)

Barium: series of X-ray, ulcers/tumors for upper GI, obstruction/malabsorption in small bowel, polyps/tumors/inflammation/intussusception in colon in enema form, NPO 6-12hr before procedure

Endoscopy: GI bleeding, ulcers, hiatal hernia, varicose, stricture, tumors

ERCP: pancreatic/biliary duct, remove stone from common bile duct

Colonoscopy: screening colon cancer/polyp/inflammation

Sigmoidoscopy: colitis/polyps/ischemia in sigmoid colon

Endoscopy + colonoscopy need NPO 6-12 prior

Oral cavity disease complications

Periodontitis→ tooth loss, destruction of alveolar bone

Untreated gum disease→ increase risk of coronary artery disease

Oral swallowing challenge→tissue change→increase cancer risk

Be aware of oral health challenges for elderly and poverty

SODH related to nutrition and overall cardiovascular health

Oral Cavity Nursing Assessment

Inspect color, texture, integrity; note mouth odor, bleeding, dentures, dental devices; assess swallowing alterations

Stomatitis

Inflammation and ulceration of oral mucosa

Type: primary(herpes simplex, traumatic ulcers), secondary(viral, bacterial, fungal)

Risk: chemotherapy(40%), radiation, infections, irritants, vitamin deficiency, systemic disease

Complications: pain, inflammation→difficulty eating/swallowing, severe case→edema in airway/systemic spread of infection

Stomatitis Nursing Management

Assess oral mucosa, monitor nutrition and weight, use viscous lidocaine (aspiration risk), antimicrobials, antivirals/antifungals, avoid alcohol mouthwash, use saline/baking soda rinses, remove painful dentures, high protein and vitamin C diet, avoid spicy/salty/hot/hard/acidic foods

What is GERD

Acid reflux erodes esophagus lining, worsened by stress; chronic can cause Barrett's esophagus and strictures

GERD Risk Factors

Obesity, older age, sleep apnea, LES relaxation due to foods, meds, hiatal hernia, overeating, delayed gastric emptying, increased abdominal pressure, lying flat

GERD s/s

Dyspepsia, regurgitation, radiating pain (neck, jaw, back), pyrosis, odynophagia, worsening pain with bending/lying, throat irritation, hypersalivation, bitter taste; relieved by water, sitting, antacids

GERD Dx

EGD (esophagus, stomach, duodenum exam with biopsy), esophageal pH monitoring, barium swallow

GERD pt education

Maintain BMI <30, stop smoking, avoid alcohol/tobacco, low-fat diet, avoid eating 2 hrs before bed, no tight clothes, elevate head of bed 6-8 inches

GERD Medications

PPIs, Antacids, H2 blockers, Prokinetics (metoclopramide)

Complication of GERD: Barrett's Esophagus

Altered esophagus structure/function from chronic GERD inflammation; linked to esophageal adenocarcinoma risk

Hiatal Hernia Definition

Stomach protrudes above diaphragm through hiatus into thoracic cavity

Type: Sliding(gastroesophageal junction); paraesophageal(rolling, fundus up, gastroesophageal down)

Hiatal Hernia Diagnosis

Similar to GERD testing

Hiatal Hernia Treatment

Same as GERD prevention and treatment; PPIs, antacids; surgery if needed

Surgical: fundoplication(Stomach fundus wrapped around esophagus to prevent reflux; complications include dysphagia, bloating, inability to belch/vomit, atelectasis, pneumonia)

Enteral Nutrition Indication

Patients with functional GI tract unable to ingest enough nutrients orally

Enteral Feeding Tube Types

NG, ND (weighted), OG, PEG/G, J tube

Enteral Nutrition Administration

Continuous or bolus feeds several times daily

Enteral Nutrition Complications

Tube irritation, misplacement (lungs), formula intolerance, diarrhea (low fiber), nutrient imbalances, reflux, aspiration

Total Parenteral Nutrition (TPN) Definition

IV nutrition for patients without functional GI tract or needing bowel rest

TPN Administration

Delivered via central venous catheter (CVC, PICC, portacath, TLC)

TPN Verification

Must be verified by two nurses before administration

TPN Lipid Bag Allergy Caution

Avoid if patient has egg allergy

TPN Complications

Central line infections, glucose abnormalities, liver dysfunction, electrolyte imbalances, gallbladder issues, lipid emulsion reactions