1. DIGESTIVE SYSTEM n ALSO KNOWN AS GI SYSTEM: GASTROINTESTINAL SYSTEM

4. AGE RELATED CHANGES n 1. FLOW OF SALIVA DECREASES Difficulty chewing/swallowing (dysphagia)

5. AGE RELATED CHANGES n 2. TASTE BUDS DECREASE -Appetite decreases

6. AGE RELATED CHANGES n 3. WEAKENED GAG REFLEX Risk of Choking

7. AGE RELATED CHANGES n 4. REDUCED DIGESTIVE JUICES Food more difficult to digest affecting absorption

8. INTRODUCTION n DIGESTIVE SYSTEM IS RESPONSIBLE FOR THE PHYSICAL AND CHEMICAL BREAKDOWN OF FOOD SO IT CAN BE TAKEN INTO THE BLOOD STREAM AND USED BY BODY CELLS AND TISSUES. n SYSTEM INCLUDES THE ALIMENTARY CANAL AND ACCESSORY ORGANS

9. ALIMENTARY CANAL n LONG MUSCULAR TUBE BEGINS AT THE MOUTH AND INCLUDES THE PHARYNX, ESOPHAGUS, STOMACH, SMALL INTESTINES, LARGE INTESTINES, RECTUM AND ANUS

11. Alimentary Canal Structures of the GI System Mouth/Oral Cavity Pharynx Esophagus Stomach Small Intestine Large Intestine Rectum Anus

12. MOUTH OR ORAL CAVITY

13. PHARYNX OR THROAT n TUBE THAT CARRIES BOTH AIR AND FOOD n CARRIES THE AIR TO THE TRACHEA OR WINDPIPE AND FOOD TO THE ESOPHAGUS

14. ESOPHAGUS n MUSCULAR TUBE BEHIND THE TRACHEA n RELIES ON A RHYTHMIC, WAVELIKE INVOLUNTARY MOVEMENT OF ITS MUSCLES, CALLED PERISTALSIS, TO MOVE THE FOOD IN A FORWARD DIRECTION

15. STOMACH RECEIVES THE FOOD FROM THE ESOPHAGUS n HOLDS FOOD APPROXIMATELY 3-4 HOURS. FOOD TURNS NTO SEMI LIQUID CALLED CHYME

16. SMALL INTESTINE n COILED SECTION OF THE ALIMENTARY CANAL ABOUT TWENTY FEET LONG AND ONE INCH IN DIAMETER. ABSORPTION DONE BY VILLI n THREE SECTIONS –DUODENUM –JEJUNUM –ILEUM

17. VILLI n FINGERLIKE PROJECTONS THAT LINE WALL OF SMALL INTESTINE n ALLOW FOOD TO BE ABSORBED OR TAKEN INTO BLOOD

19. DUODENUM n FIRST NINE TO TEN INCHES

20. JEJUNUM n ABOUT EIGHT FEET LONG n FORMS THE MIDDLE SECTION OF THE SMALL INTESTINE

21. ILEUM n FINAL TWELVE FEET n CONNECTS WITH THE LARGE INTESTINE

23. SMALL INTESTINE OVERVIEW Nutrients are ABSORBED from the small intestine into the blood stream by the VILLI

24. LARGE INTESTINE n ABOUT FIVE FEET LONG AND ABOUT TWO INCHES IN DIAMETER

25. FUNCTIONS n REABSORPTION OF WATER n TRANSPORTATION OF THE WASTE PRODUCTS OUT OF THE ALIMENTARY CANAL

26. SECTIONS OF LARGE INTESTINE (COLON) n 1. ASCENDING COLON n 2. TRANSVERSE COLON n 3. DECENDING COLON n 4. SIGMOID COLON

28. RECTUM n FINAL SIX TO EIGHT INCHES of alimentary canal n STORAGE AREA FOR WASTES n ANUS: Evacuation of waste

30. ACCESSORY ORGANS n INCLUDE THE LIVER, GALLBLADDER, PANCREAS AND APPENDIX

32. LIVER n LARGEST GLAND IN THE BODY n LOCATED UNDER THE DIAPHRAGM IN THE UPPER RIGHT QUADRANT OF THE ABDOMEN

34. FUNCTIONS OF LIVER n SECRETES BILE n REMOVES TOXINS FROM BODY n PRODUCES CHOLESTEROL

35. GALLBLADDER n SMALL MUSCULAR SAC n LOCATED UNDER THE LIVER n STORES BILE

37. PANCREAS n FISH-SHAPED ORGAN LOCATED BEHIND THE STOMACH n PRODUCES PANCREATIC JUICES AND INSULIN

39. DISEASES OF THE DIGESTIVE SYSTEM

40. APPENDICITIS n ACUTE INFLAMMATION OF THE APPENDIX USUALLY DUE TO AN OBSTRUCTION AND INFECTION

42. GALLBLADDER CONDITIONS CHOLECYSTITIS-INFLAMMATION OF THE GALLBLADDER CHOLELITHIASIS: GALLSTONES

43. SYMPTOMS n FREQUENTLY OCCUR AFTER EATING FATTY FOODS –INDIGESTION, N&V –PAIN UNDER RIB…WHAT SIDE? –JAUNDICE

44. TREATMENT LOW FAT DIET SURGERY LASER TO BREAK UP GALLSTONES

46. CIRRHOSIS n CHRONIC DESTRUCTION OF LIVER CELLS ACCOMPANIED BY THE FORMATION Of SCAR TISSUE n CAUSES: ALCOHOLISM

48. MALIGNANCY: CANCERS SYMPTOMS DEPEND ON LOCATION: obstruction Indigestion Vomiting Change in stools Blood in stools (old/new)

49. TREATMENT FOR CANCERS SURGERY: COLOSTOMY- CREATION OF ARTIFICAL OPENING IN ABDOMINAL WALL AND BRINGING SECTION OF COLON TO IT FOR ELIMINATION OF STOOL ILEOSTOMY- CREATION OFARTIFICIAL OPENING AND BRINGING SECTION OF ILEUM THROUGH IT

51. HEPATITIS n VIRAL INFLAMMATION OF THE LIVER n TYPE A OR INFECTIOUS HEPATITIS –HIGHLY CONTAGIOUS –TRANSMITTED IN FOOD OR WATER THAT HAS BEEN CONTAMINATED BY THE FECES OF AN INFECTED PERSON n TYPE B/TYPE C –TRANSMITTED BY BLOOD AND SERUM –MORE SERIOUS THAN TYPE A AND CAN LEAD TO CHRONIC HEPATITIS OR CIRRHOSIS OF THE LIVER

52. SYMPTOMS n FEVER, LOSS OF APPETITE n N&V n FATIGUE n ENLARGED LIVER n JAUNDICE

53. ULCER n OPEN SORE ON THE LINING OF THE DIGESTIVE TRACT

55. SYMPTOMS n BURNING PAIN n INDIGESTION n HEMATEMESIS (BLOODY VOMITUS) n DARK,TARRY STOOL

56. TREATMENT n MEDICATION n DIET MODIFICATION n ANTIBIOTICS n NPO n POSSIBLY NG TUBE

57. ULCERATIVE COLITIS n SEVERE INFLAMMATION OF THE COLON WITH THE FORMATION OF ULCERS AND ABSCESSES n THOUGHT TO BE CAUSED BY STRESS, ALLERGIC REACTIONS TO FOOD, OR AN AUTOIMMUNE REACTION

58. SYMPTOMS n WATERY, FREQUENT STOOLS WITH BLOOD, PUS, AND MUCUS n WEIGHT LOSS n DEHYDRATION n FLARE-UPS ARE COMMON

61. TREATMENT n DIRECTED TOWARD CONTROLLING INFLAMMATION n REDUCE STRESS n MAY NEED SURGERY

62. GI BLEED INTERNAL BLEEDING IN DIGESTIVE TRACT: OCCULT BLOOD- HIDDEN BLOOD/NOT SEEN WITH NAKED EYE UPPER GI BLEED- COMING FROM STOMACH AND STRUCTURES ABOVE LOWER GI BLEED-COMING FROM INTESTINES AND STRUCTURES BELOW

63. BLOOD IN GI SYSTEM NEW: BRB OLD: BLACK, TAR LIKE “COFFEE GRINDS”

64. GI BLEED: SYMPTOMS LOWER GI BLEED: (Intestine to rectum) RECTAL BLEEDING (BRB/BLACK TARRY STOOLS) HYPOTENSION DIAPHORETIC

65. GI BLEED: SYMPTOMS UPPER GI BLEED: (Stomach to mouth) VOMITING BLOOD (BRB/COFFEE GRINDS) HYPOTENSION DIAPHORETIC

66. DIAGNOSTIC TEST for OCCULT BLOOD HEMACULT BLOOD TEST: USED TO DETECT BLOOD IN STOOL AND EMESIS

68. LOWER BOWEL CONDITIONS n CONSTIPATION- fecal material is hard, dry or sticky n DIARRHEA- 3 or more loose stools w/in a certain amount of time

69. Factors that Affect Bowel Function n Bed rest n Immobility n Inadequate exercise n Decreased fluid intake n Change in environment

70. Abdominal Distention As food moves through tract, gas is formed and is normally expelled from body. If not passed, it accumulates in intestines, enlarging the abdomen

71. C. difficile n Bacteria transmitted on HCW hands after they touch feces or contaminated surfaces (faucets, side rails) and can be transmitted to other patients.

72. Feeding Tubes 1. Nasogastric Tube (NG) –goes from nose to stomach 2. Gastrostomy Tube (GT)- goes directly into stomach

73. Nasogastric Tube (NG) Always NPO for tube feedings because of the reasons they are on tube feedings! HOB at least 30 degrees or higher RN inserts NG tube and checks for placement

74. Nasogastric Tube Can be used for: Tube feedings called GAVAGE (mostly short term feedings) Or Suctioning out contents of stomach called LAVAGE

77. GastrostomyTube (GT) n Tube for feedings that goes directly into abdomen through a surgical incision. n More for long-term feedings n HOB at least semi-fowlers