| three major sections of the small intestine | 1. duodenum
2. jejunum
3. ileum |
| how much digestion takes place in the small intestine? | 90% |
| the appendix functions as an area where no pathologic bacteria live safely until they are needed for ______ | digestion |
| the appendix houses what? | immune system cells and tissue |
| approximately ______ mL’s of blood is delivered to the liver every minute | 1500mL’s |
| the cells of the liver produce ______, a yellow-brown or brown-green liquid, and it is necessary for what? | bile
necessary for the emulsification of fats |
| the liver releases approximately ______ mL’s of bile each day | 500-1000mL’s |
| bile from the liver travels to the ________ through ______ ____ | gallbladder through hepatic ducts |
| the gallbladder is a sac about _____cm’s and it is located where? | 8-9cm (3-4in)
on the right inferior surface of the liver |
| bile is stored in the gallbladder until it is needed for what? | fat digestion |
| the hypothalamus, a portion of the brain, contains two appetite centers that do what? | affect eating |
| one center of the hypothalamus stimulates the individual to ____ and the other signals the individual to ____ ______ | eat and not eat |
| the centers in the hypothalamus work in conjunction with the rest of the brain to do what? | balance eating habits |
| in addition to the hypothalamus, factors that affect food intake include l______, c_______, e________h_______, e________, and g________ | lifestyle, culture, eating habits, emotions, and genetics |
| (diagnostic: EGD - nursing interventions)
- patient will not be allowed to eat or drink until when?
- this test addressed by doing what? | - the gag reflex returns
- placing a tongue blade to the back of the pharynx |
| (diagnostic: stool for occult blood - nursing interventions)
- the patient should not eat any organ meat for _____ before what? | - 24-48 hours before a guaiac test |
| (diagnostic: barium enema study - nursing interventions)
the evening before a barium enema study, cathartics such as magnesium are administered, and a cleansing enema. after a barium study ______ may be ordered, and you should assess the patient for what? as well as instruct the patient to do what at home? | laxative
assess the patient for complete evacuation of the barium, and instruct the patient to monitor stools |
| retained barium may cause ______ or ______, and stool will appear how? until all the barium is expelled | constipation or hardened impaction
light in color |
| for a stool culture, ______ stool specimens are collected on consecutive days | three |
| dental decay can be caused by several factors such as:
(4) | - dental plaque, a thin film on the teeth in saliva and often secondarily invaded by bacteria
- strength of acids and the inability of the saliva to neutralize them
- length of time the acids are in contact with the teeth
- susceptibility of the teeth to decay |
| cancer of the lip occurs most frequently as what? in men over the age of ______ | a chronic ulcer of the lower lip
50 |
| (disorder of the mouth: carcinoma of the oral cavity - medical management)
large tumors usually require more extensive and traumatic surgery, in functional neck dissection of the neck cancer with no growth in the lymph nodes, the surgeon removes the lymph nodes but preserves the _______ ____, the _____________ ______ and the _____ ________ _____ | jugular vein
sternocleidomastoid muscle
spinal accessory nerve |
| (disorder of the mouth: carcinoma of the oral cavity - medical management)
in radical neck dissection, all these structures are removed (lymph nodes, jugular vein, the sternocleidomastoid muscle, and spinal accessory nerve) AND what? is necessary after tissue resection | reconstructive surgery |
| (disorder of the mouth: carcinoma of the oral cavity - medical management)
patients may have drains in the incision sites that are connected to suction to ___ __________ and _______ _________ | aid healing
reduce hematomas |
| (disorder of the esophagus: GERD - clinical manifestations)
heartburn often is described as a substernal or retrosternal burning sensation that tends to _______ _________ and may involve the ______, ______, or the _______ | radiate upward
neck, the jaw, or the back |
| (disorder of the esophagus: GERD - clinical manifestations)
heartburn usually is experienced after eating, an atypical pain pattern that closely mimics _______
and heartburn must be differentiated carefully from what? | angina
true cardiac disease |
| (disorder of the esophagus: GERD - clinical manifestations)
GERD primary and secondary symptoms | primary: irritation of chronic reflux, produces heartburn
secondary: regurgitation |
| (disorder of the esophagus: GERD - medical management)
metoclopramide (raglan) is used in moderate to severe cases of GERD, it is in a class of drugs called what?
these drugs increase peristalsis and therefore promote gastric emptying and reduce the risk of what? | promobility agents
gastric acid reflux |
| (disorder of the esophagus: carcinoma of the esophagus - pathophysiology)
unfortunately, early esophageal cancer typically has ___ ________ that makes early diagnosis difficult | no symptoms |
| nursing interventions for the patient experiencing esophageal surgery: postoperative nursing interventions:
1. promote good-
2. maintain chest-
3. maintain gastric-
4. maintain- | 1. pulmonary circulation
2. drainage system
3. drainage system
4. nutrition |
| (disorder of the stomach: gastritis (acute) - assessment)
collection of objective data includes observing for what? and melanoma caused by what? | vomiting, hematemesis (vomiting blood), and melenoma caused by gastric bleeding |
| (disorder of the stomach: peptic ulcer disease - pathophysiology)
the most common caused of peptic ulcer disease include the presence of what? where? | helicobacter pylori (H. pylori) bacteria in the stomach |
| (disorder of the stomach: peptic ulcer disease - assessment)
collection of objective data includes observing for signs of complications, _________ is a potential complication of PUD | hemorrhage |
| (disorder of the stomach: peptic ulcer disease - assessment)
when GI bleeding occurs, one sign is the vomiting of blood (hematemesis) that appears as what, resulting from what? | either bright red, or a “coffee grounds”, the action of the gastric acid on hemoglobin |
| (disorder of the stomach: peptic ulcer disease - assessment)
the patient may produce melena when GI bleeding occurs, melena is what? | stool that is black and tarry with undigested blood |
| (disorder of the stomach: peptic ulcer disease - assessment)
bleeding from a gastric ulcer can worsen quickly into an emergency situation if erosion is extensive, hemorrhage has an accompanying symptom of ______ and it occurs when? | shock, when the ulcer erodes into a blood vessel |
| (disorder of the stomach: peptic ulcer disease - assessment)
this is considered the most lethal complication of PUD | perforation |
| (disorder of the stomach: peptic ulcer disease - medical management)
histamine receptor blockers decrease acid secretions by blocking histamine receptors, some medications are ______, _______, ______, ______ and they should they not be given within when?
(hint: “dine”) | cimetidine, ranitidine, famotidine, nizatidine
2 hours of antacids |
| (medications for GI disorders)
name a proton pump inhibitor and nursing intervention | omeprazole - do not crush or chew |
| purposes of nasogastric intubation
- d_____________
- f_______ (______)
- c___________
- l_______ | - decompression
- feeding (gavage)
- compression
- lovage |
| dumping syndrome is a rapid gastric emptying of undigested food to the small intestine, causing what? | distention of the duodenum or jejunum |
| dumping syndrome is the direct result of surgical removal of a large portion of what? | the stomach and pyloric sphincter |
| treatment of dumping syndrome includes eating six small meals daily that are high in _______ and ____ and low in __________, and they should eat slowly and avoid fluids during ______ | high in protein and fat and low in carbohydrates
meals |
| treatment of dumping syndrome includes anticholinergic agents that do what? and reclining for approximately __ hour after meals | decrease stomach mobility
1 |
| (disorder of the intestine: infection - pathophysiology)
antidiarrheals should not be given because these medications prevent the intestines from what? | getting rid of the E. coli pathogen |
| (disorder of the intestine: infection - nursing interventions)
assessment for fluid balance is important, including
1. skin turgor
2. mucous membrane hydration
3. urinary output
4. and measurement of postural changes in what? | blood pressure |
| (disorder of the intestine: celiac disease (celiac sprue) - pathophysiology)
celiac is a genetic disorder that most commonly affects the small intestine but can affect any part of the GI system, it is considered an autoimmune disease that disrupts the absorption of nutrients from foods in response to what? | the ingestion of gluten (a protein primarily found in wheat, rye, and barely) |
| (disorder of the intestine: celiac disease (celiac sprue) - pathophysiology)
when these proteins are ingested (gluten), the immune system begins damaging the inner lining of the small intestine and destroying the _____ | villi |
| (disorder of the intestine: IBS - pathophysiology)
anxiety disorders, depression, and forms of abuse, including physical, social, and sexual, are considered what? | possible causes of IBS |
| (inflammatory bowel disease: ulcerative colitis - clinical manifestations)
patients with severe ulcerative colitis may have as many as ___-___ liquid stools per day, and these liquid stools contain _____, _____, and ____ | 15-20
blood, mucus, and pus |
| (inflammatory bowel disease: ulcerative colitis - clinical manifestations)
abdominal cramps may occur before the bowel movement, the urge to defecate lessens as what? progresses, and this results in what? | scarring within the bowel,
involuntary leakage of stool |
| (inflammatory bowel disease: chron’s disease - pathophysiology)
chron’s disease can occur anywhere in the GI tract from the mouth to the anus but occurs most commonly where? | in the terminal ileum and proximal colon |
| (inflammatory bowel disease: chron’s disease - nursing interventions)
tube feedings that allow rapid absorption in the upper GI tract are begun and then oral intake of a what? diet is introduced gradually | a low-residue, high-protein, high-calorie |
| (inflammatory bowel disease: chron’s disease - nursing interventions)
when anemia is present, iron dextran is given by z-tract injection (because of irritation to the tissues) because oral intake of iron is what? | ineffective because of intestinal ulceration |
| (acute abdominal inflammation: diverticulosis and diverticulitis - clinical manifestations)
when diverticula perforate and diverticulitis develops, the patient complains of mild to severe pain in the left lower quad of the abdomen, and what else? | a fever, elevated WBC, and erythrocyte sedimentation rate, as well as the patient generally being hypotensive and tachycardic |
| (acute abdominal inflammation: diverticulosis and diverticulitis - clinical manifestations)
if the condition goes untreated, ________ and _____ _____ can develop? | septicemia and septic shock |
| (acute abdominal inflammation: diverticulosis and diverticulitis - clinical manifestations)
intestinal obstruction can occur, causing _______ _______, _______, and _______ | abdominal distention, nausea, and vomiting |
| (acute abdominal inflammation: diverticulosis and diverticulitis - medical management)
a diet high in fiber, mainly from where?, and a decreased intake of what? are recommended for preventing diverticular disease | fresh fruits and vegetables
fat and red meat |
| (acute abdominal inflammation: peritonitis - nursing interventions)
nursing interventions for the patient with peritonitis include:
- place the patient on bed rest in semi fowler’s position to help what? where?
- give oral hygiene to prevent dying of what? and crackling of what? from what?
- monitor fluid and electrolyte __________
- encourage deep breathing exercises; patient tends to have what? as a result of what?
- use measures to reduce ______
- use meticulous surgical asepsis for wound care, instruct patient about the importance of what? | - localize purulent exudate in the lower abdomen or pelvis
- mucous membranes and crackling of lips from dehydration
- fluid & electrolyte replacement
- shallow respirations as a result of abdominal pain or distention
- reduce anxiety
- ambulation, coughing, deep-breathing, incentive spirometer & leg exercises |
| (hernias: external hernias - pathophysiology)
the hernia is strangulated when it occludes what?, to prevent anaerobic infection in the area, what? is performed when a hernia strangulated | occludes blood supply and intestinal flow
immediate surgical intervention |
| (hernias: external hernias - pathophysiology)
if complications such as what? follow, the patient may have what? | incarceration or strangulation
bowel obstruction, vomiting, abdominal distention |
| (hernias: external hernias - nursing interventions)
the patient should deep breathe every ___ hours, but many surgeons discourage ________. teach the patient how to support the incision by what? | 2 hours
coughing
splinting the area with a pillow or pad |
