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: Esophagus

Stiffening, decreased peristalsis, decreased gastric emptying

Age-Related GI Subjective Symptoms: Esophagus

Chest pain, eructation, heartburn, indigestion, early satiety, OTC GERD treatment, weight loss

Age-Related GI Objective Signs: Esophagus

Weight changes

Age-Related GI Changes: Liver

Decreased bile synthesis, widened bile duct, increased cholecystokinin secretion

Age-Related GI Symptoms: Liver

Right upper quadrant pain, early satiety, decreased appetite; skin inspection, abdominal palpation

Age-Related GI Changes: Pancreas

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

Age-Related GI Symptoms: Pancreas

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

Age-Related GI Changes: Hepatic

Decreased hepatic cells, enzyme activity, cholesterol synthesis

Age-Related GI Symptoms: Hepatic

Medication use, alcohol intake; abdominal percussion and palpation

Age-Related GI Changes: Intestines

Decreased peristalsis, mucus secretion, elasticity, sensation

Age-Related GI Symptoms: Intestines

Bowel movement frequency, bloating, urgency, straining, incontinence; bowel sounds, percussion, rectal exam

CBC Purpose in GI

Detects blood loss, inflammation/infection

BMP Purpose in GI

Detects electrolyte imbalances from absorption/excretion issues

CMP Purpose in GI

Includes albumin (nutritional status) and liver function tests

Liver Function Tests (LFTs)

ALT (males 13-40, females 24-36), AST (males 20-40, females 15-35), total bilirubin (0.3-1 mg/dL)

Stool Tests Used For

Blood, bacteria, parasites

Gastric Fluid Tests

Checks for blood, bacteria, medications, acidity

Abdominal X-ray Shows

Masses, obstruction, strictures, air indicating obstruction

Ultrasound Uses

Assesses organs/blood vessels, ascites, cysts, tumors, stones, aneurysms; used if contrast contraindicated; guides stent placement

Barium Studies

Prior NPO 12 hrs; examines GI tract for swallowing issues, ulcers, tumors, obstruction, polyps, intussusception

Endoscopy Purpose

Visualizes GI tract for diagnosis, cure, or palliation; identifies bleeding, ulcers, hernia, varices, strictures, tumors

Colonoscopy Purpose

Screening for colon cancer, polyps, inflammation; NPO 6-12 hrs before

Periodontitis Effects

Leads to tooth loss and alveolar bone destruction

Oral Cavity Nursing Assessment

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

Stomatitis Definition

Inflammation and ulceration of oral mucosa

Stomatitis Types

Primary (herpes simplex, traumatic ulcers), Secondary (viral, bacterial, fungal infections)

Stomatitis Risk Factors

Chemotherapy, radiation, infections, vitamin deficiency, systemic disease

Stomatitis Complications

Pain, inflammation causing difficulty eating/swallowing

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

GERD Description

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 (fatty, chocolate, caffeine), meds, hiatal hernia, overeating, delayed gastric emptying, increased abdominal pressure (obesity, pregnancy, ascites), lying flat

GERD Clinical Manifestations

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 Diagnostic Tests

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

GERD Prevention & Treatment

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 (pantoprazole, omeprazole, esomeprazole, rabeprazole, lansoprazole), Antacids (aluminum hydroxide, magnesium hydroxide, calcium carbonate, sodium bicarbonate), H2 blockers (famotidine, cimetidine, nizatidine), Prokinetics (metoclopramide)

Complication of GERD: Barrett's Esophagus

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

GERD Patient Education Foods to Avoid

Spicy, fatty/fried foods, caffeine, chocolate, carbonated drinks, acidic foods, peppermint

GERD Patient Education Additional Advice

Avoid smoking/alcohol, avoid NSAIDs and aspirin, wear loose clothing, maintain BMI <30

Hiatal Hernia Definition

Stomach protrudes above diaphragm through hiatus into thoracic cavity

Hiatal Hernia Sliding Type

Most common; stomach and gastroesophageal junction move above diaphragm with increased pressure or lying down

Hiatal Hernia Paraesophageal Type

Part of stomach fundus moves above diaphragm; gastroesophageal junction stays below

Hiatal Hernia Diagnosis

Similar to GERD testing

Hiatal Hernia Treatment

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

Hiatal hernia: Fundoplication Procedure

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

Fundoplication Indications

Clients not responding to medical GERD treatment

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