Gastrointestinal System

Lecture 14

GI tract

• Mouth • Pharynx • Esophagus • Stomach • Small intestine • Large intestine

Esophagus

• Moves food via…• Peristalsis– “Alternating waves of

contraction and relaxation”

Stomach

• Mixes food with gastric juices – Chyme

• Pyloric sphincter– Controls stomach

emptying

• Stomach empties completely within 4-6 hours after a meal

Small intestine

• 3 areas– Duodenum

• Pancreas enzymes +• Bile

– Jejunum– Ileum

• Almost all food, water, vitamins and mineral are absorbed out of small intestines

Large Intestine

• AKA:– Colon

Accessory organs

• Liver• Gallbladder• Pancreas

Liver & Gallbladder

• Produces bile– Greenish– Emulsifies fats

• Extra bile is stored in the – Gallbladder

• Bile flows into– duodenum via – bile duct

Pancreas

• Secretes enzymes for food digestion

Nutrients

• “Substances in food that are used by the body for growth, maintenance and repair”– Carbohydrates– Protein– Fats– Vitamins– Minerals – Water

Metabolism

• Chemical reactions that happen in the cells in order to sustain life– Catabolism

• Breaking down structures for fuel

• “Burning”

– Anabolism• Combining simpler

molecules to build more complex structures

• “Building”

Carbohydrates

• Simple (sugar)– Sugar– Fruits

• Complex (Starch)– Grains– Legumes– vegetables

Carbohydrates

• Function– Convert to glucose – ATP – Fuel for the cells

Proteins

• Composed of amino acids• Complete proteins

– Milk– Meat– Fish– Poultry

• Plant proteins– Legumes– Nuts– Grains– Cereals

Protein

• Function– Vital for body structure

and function– Building and rebuilding

of tissue

Assessment

• Height & weight• Auscultate bowel

sounds– All 4 quadrants– Normal q 5-15 sec

• Palpate abdomen

Diagnostic Test

• Upper endoscopy• Exam esophagus,

stomach, duodenum and upper jejunum.

• Used to ID– Swallowing difficulty– Gastric reflux– Ulcers

Upper Endoscopy: Nrs Care

• Fasting 8 hours• Conscious sedation• Remove dentures• Hold food until gag &

cough reflex return• Warm saline gargles or

throat lozenges for comfort

Colonoscopy

• Visual examination of large intestine

• Used to – Screen for cancer– Remove polyps

Colonoscopy: Nrs Care

• Bowel prep• Conscious sedation

Terms: N/V

• Anorexia– Loss of appetite

• Nausea– Vague, unpleasant

sensation of sickness or queasiness

• Vomiting– Forceful expulsion of

stomach contents

N&V interventions

• Self limiting• Hold food initially • Clear liquids• Dry foods • Ginger

Inserting an NGT

• Standard precaution• Position– High Fowler’s

• Measure– Tip of nose– Earlobe– Distal sternum

Enteral Feeding

• HOB 30o

• Check tube placement– 30 mL air – Check residual

• Reinstill aspirated contents – > 100 mL GT– > 200 mL NGT

• Notify MD

Enteral feeding

• 30 mL water flush– a/– p/

Stomatitis

• Inflammation of the oral mucosa

Stomatitis: Nrs Care

• Oral care p/ eating• Avoid alcohol based

mouthwashes• High calorie & protein

diet• Soft, lukewarm or cool

foods• Small frequent meals• Avoid spicy foods

Gastroesophageal Reflux Disease

• Backwards movement of gastric content

• GERD• S&S– Heartburn– Sore throat– hoarsness

GERD: Nrs Care

• Avoid lying down (3 hr) p\ meals

• HOB up 6 inches• Avoid alcohol and

tobacco• Weight loss promotion• Avoid acidy foods• Administer meds– Histamin-2 receptor

blockers

Peptic Ulcer Disease (PUD)

• Break in the mucous lining of the stomach or duodenum where it comes in contact with gastric juice

PUD – S&S

• Pain– Burning, aching, unger-

like– Relieved by eating– Heartburn

• Elderly– No symptoms

PUD - complications

• Hemorrhage– Hematemesis– Orthostatic hypotension– Occult stool– Fatigue, weak

• Obstruction– Feel full– N&V

• Perforation– Severe pain– No BS