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Chapter 5 & 6 semester 2


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[Front]


what is peristalsis
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the coordinated, rhythmic, sequential contraction of smooth muscle that push food through the digestive tract, as well as bile through the bile duct

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What is peristalsis
The coordinated, rhythmic, sequential contraction of smooth muscle that push food through the digestive tract, as well as bile through the bile duct
Where does digestion begin
In the mouth; the teeth mechanically shred and grind food and enzymes begin the chemical breakdown of carbohydrates
Where is that he stomach located
LUQ of the abdomen, directly inferior to the diaphragm
Where is the entrance and exit of the stomach
At the cardiac sphincter; the exit is at the pyloric sphincter
Where is the appendix located
Inferior to the ileocecal valve is the cecum; the appendix dangles from the cecum
What is the function of the appendix
An area where non pathologic bacteria live safely until they are needed for digestion; and house immune system cells and tissue
Where is the liver located
Inferior to the diaphragm, covering most of the URQ and extending into the left epigastrium, and is divided into two lobes
How much blood is delivered to the liver
Every minute approximately 1500ml
The cell of the liver produce bile define it and why its necessary
A yellow-brown or green-brown liquid; for the emulsification of fat
What is the primary function of the gallbladder
Store and eject bile into the duodenum for digestion of fats
Where is the pancreas
Lies posterior to the stomach
What does the pancreases produce each day
1000-1500mL of pancreatic juice to aid in digestion
Define anchlorhydria
An abnormal condition characterized by the absence of hydrochloric acid in the gastric juice
Melena
Tar-like, fetid-smelling stool containing undigested blood
What are the 4 major functions of the large intestine
Completion of absorption of water; manufacture of vitamins K & B7; formation of feces; expulsion of feces
How can you assess if the pt gag reflux has returned
Placing a tongue blade to the back of the pharynx
Define lumen
The cavity or channel within a tube or tubular organ
Occult blood
It is obscure or hidden away from view
A barium enema study does what
Series of x-rays of the colon used to detect the presence and location of abnormalities such as polyps, tumor, and diverticula
Intussusception
Infolding of one segment of the intestine into the lumen of another segment
What does a colonoscopy do
Visualizes the mucosa of the colon and can detect lesions in the proximal colon, which would not be found by sigmoidoscopy
What are the dietary restrictions prior to a colonoscopy
Clear liquid diet 1-3 days before procedure to decrease residue in the bowel, and NPO for 8 hours before the procedure
After a colonoscopy what will you monitor the pt for
Abdominal pain, guarding, distention, tenderness, excessive rectal bleeding, or blood clots
Usually at least ___ ____ ____ are collected on consecutive days
Three stool specimens; because the result are not available for several days and guide subsequent treatment if bacterial infection is present
Pathognomonic
Signs or symptoms specific to a disease condition
Cancer of the lips occurs most frequently as a
Chronic ulcer of the lower lips in men over the age of 50
Leukoplakia
A white, firmly attached patch on the mouth or tongue mucosa; may appear on the lips and buccal mucosa
Dysphagia
Difficulty swallowing
Define supraglottic laryngectomy
Removal of the entire larynx or the portion of the true vocal cords
Large tumors require more ___ and ___ ___
Extensive, traumatic surgery
Heartburn often described as a
Substernal or retrosternal burning sensation that tends to lead to radiate upward and may involve the neck, the jaw, or the back
Reglan is used to treat moderate to sever cases of GERD, it is in a class of drugs called
Promotility agents, which increase peristalsis & therefore promote gastric emptying & reduce the risk of gastric reflux
Early esophageal cancer typically has
No symptoms, making early diagnosis difficult; and greatly affects the 5 year survival rate
Anastomosis
Surgical joining of two ducts, blood vessels, or bowel segments to allow flow from one to the other
In carcinoma of the ___ the malignancy tends to ________
Esophagus; spread to the nearby lymph nodes
Achalasia also called cardiospasm means
An abnormal condition characterized by the inability of a muscle to relax, particularly the cardiac sphincter of the stomach
What are the four post op intervention for a pt experiencing esophageal surgery
Promote good pulmonary ventilation, maintain chest drainage system as prescribed, maintain gastric drainage system, maintain nutrition
Observing for the s/s of gastritis include
Anorexia, nausea, discomfort, after eating and pain
Objective data of gastritis includes observing
Vomiting, hematemesis (vomiting blood), & melena caused by gastric bleeding
The most common causes of peptic ulcers include
The presence of H. pylori bacteria in the stomach, regularly taking NSAIDs, smoking or chewing tobacco, excessive alcohol intake
The term peptic ulcer refers to
Acid in the digestive tract eroding the mucosal lining of the stomach, esophagus, or duodenum
Define perforation
Occurs when the ulcer crater penetrates the entire thickness of the wall of the stomach duodenum
Histamine receptor blockers
Do not give within two hours of antacids; decrease acid secretions by blocking histamine (H2) receptors ;
What is the action of omeprazole (Prilosec)
Proton pump inhibitor; totally eradicates gastric acid production
What are the purposes of nasogastric intubation
Decompression, feeding (gavage), compression, lavage
Define dumping syndrome
A rapid gastric emptying of undigested food from the stomach to the small intestine, causing distention of the duodenum or jejunum
Dumping syndrome is a direct result of
Surgical removal of a large portion of the stomach and pyloric sphincter
Dehiscence
A partial or complete separation of the wound edge
Evisceration
Protrusion of viscera through the disrupted wound
Treatment of dumping syndrome include
Six small meals high in protein & fat, low in carbs, eating slowly & avoiding fluids during meals; anticholingeric gets 2 decrease motility; reclining for at least one hour AC
Why do you not give antibiotics for cancer of the stomach
Long term therapy can destroy the normal flora, resulting in pathogenic microorganisms entering the intestines
One strain of E. coli is
O157:H7; often has a virulent course
Why would you not give a pt antidiarrheals if they have disorders of the intestines
Prevent the intestines from getting rid of the E. coli pathogen
Define tenesmus
Ineffective and painful straining with with defecation
What are nursing interventions for intestine infections
Fluid imbalance is important, including measurements of postural changes in BP, skin turgor, mucous membrane hydration, and urinary output. ( dehydration & hypotension)
Celiac disease patho
Autoimmune disease that disrupts they absorption of nutrients from foods in response to the ingestion of gluten
Gluten
A protein primarily found in wheat, rye, and barley
IBS patho
Episodes of altered bowel function and intermittent and recurrent abdominal discomfort and pain
One theory for IBS is
The brain, intestine, and nervous system interact in a way that causes greater than normal discomfort when stool passes through the colon
Physiological factors also are considered for IBS include
Anxiety, depression, and forms of abuse including physical, social, and sexual abuse
Define exacerbations
Increase in severity of the symptoms
Define remission
Decrease in severity of the disease or any of its symptoms
Ulcerative colitis s/s
Severe diarrhea, losses of sodium, potassium, bicarbonate, and calcium irons may occur
In mild to moderate ulcerative colitis what s/s may occur
Diarrhea may consist of two to five stools per day with some blood present
Pt with severe ulcerative colitis s/s may include
Fifteen to twenty liquid stools per day, containing blood, mucus, and pus
Stoma
An artificial opening of an internal organ on the body surface; color and size should be pink/red and slightly edematous
Where can crowns disease occur
Any where in the GI tract from the mouth to the anus but most commonly in the terminal ileum and proximal colon
Define steatorrhea
Excess fat in the feces
Crohns disease dieting nursing interventions
Tube feeding allow rapid absorption in the GI tract that begun, and the oral intake of a low-residue, high protein, high calorie diets are introduced gradually
Clinical manifestations for diverticulitis
Pain in the left quadrant of abdomen, fever, elevated WBC count, erythrocyte sedimentation rate
Untreated clinical manifestations for diverticulitis
Septicemia and septic shock can develop, hypotensive, tachycardic, intentional obstruction can occur, abdominal distention, n/v
Recommended diet for diverticulitis
High in fiber, mainly fresh fruits and vegetables, decreased intake of fat and red meat
External hernia is strangulated when what happens
Occludes blood supply and intestinal flow
Post op nursing interventions for a pt with strangulated hernia
Pt should deep breathe every 2 hours but mainly surgeons discourage coughing; teach the pt how to support the incision by splinting the area with a pillow or pad
Define volvulus
A twisting of bowel onto itself
Define paralytic (adynamic) ileus
Lack of intestinal peristalsis and bowel sounds
Define cachexia
Weakness and emaciation associated with general ill health and malnutrition (small body and big belly)
Define hepatitis
An inflammation of the liver caused by viruses, bacteria, and noninfectious causes such as alcohol ingestion and drugs
Define parenchyma
The functional tissue of an organ, as opposed to supporting or connective tissue
Define biliary atresia
The absence of underdevelopment of biliary structures that is congenital in nature
Define ascites
An accumulation of fluid and albumin in the peritoneal cavity
Define hypoalbuminemia
Reduced protein or albumin level in the blood, which reduces the bloods ability to regain fluids through osmosis
Define spider telangiectasis
Small, dilated blood vessels with a bright red center point and spider like branches
Define jaundice
Yellow discoloration of the skin, mucous membranes, and sclera of the eyes caused by greater than normal amounts of bilirubin in the serum
Define paracentesis
A procedure in which fluid is withdrawn from the abdominal cavity
Define esophageal varices
A complex of longitudinal, tortuous vein at the lower end of the esophagus