1. Gastrointestinal System Lecture 14

2. GI tract Mouth  Pharynx  Esophagus  Stomach  Small intestine  Large intestine

3. Esophagus Moves food via… Peristalsis – “Alternating waves of contraction and relaxation”

4. Stomach Mixes food with gastric juices  – Chyme Pyloric sphincter – Controls stomach emptying Stomach empties completely within 4-6 hours after a meal

5. Small intestine 3 areas – Duodenum Pancreas enzymes + Bile – Jejunum – Ileum Almost all food, water, vitamins and mineral are absorbed out of small intestines

6. Large Intestine AKA: – Colon

7. Accessory organs Liver Gallbladder Pancreas

8. Liver & Gallbladder Produces bile – Greenish – Emulsifies fats Extra bile is stored in the – Gallbladder Bile flows into – duodenum via – bile duct

9. Pancreas Secretes enzymes for food digestion

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

11. 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”

12. Carbohydrates Simple (sugar) – Sugar – Fruits Complex (Starch) – Grains – Legumes – vegetables

13. Carbohydrates Function – Convert to glucose  – ATP  – Fuel for the cells

14. Proteins Composed of amino acids Complete proteins – Milk – Meat – Fish – Poultry Plant proteins – Legumes – Nuts – Grains – Cereals

15. Protein Function – Vital for body structure and function – Building and rebuilding of tissue

16. Assessment Height & weight Auscultate bowel sounds – All 4 quadrants – Normal q 5-15 sec Palpate abdomen

17. Diagnostic Test Upper endoscopy Exam esophagus, stomach, duodenum and upper jejunum. Used to ID – Swallowing difficulty – Gastric reflux – Ulcers

18. 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

19. Colonoscopy Visual examination of large intestine Used to – Screen for cancer – Remove polyps

20. Colonoscopy: Nrs Care Bowel prep Conscious sedation

21. Terms: N/V Anorexia – Loss of appetite Nausea – Vague, unpleasant sensation of sickness or queasiness Vomiting – Forceful expulsion of stomach contents

22. N&V interventions Self limiting Hold food initially Clear liquids Dry foods Ginger

23. Inserting an NGT Standard precaution Position – High Fowler’s Measure – Tip of nose – Earlobe – Distal sternum

24. Enteral Feeding HOB 30 o Check tube placement – 30 mL air – Check residual Reinstill aspirated contents – > 100 mL GT – > 200 mL NGT Notify MD

25. Enteral feeding 30 mL water flush – a/ – p/

26. Stomatitis Inflammation of the oral mucosa

27. 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

28. Gastroesophageal Reflux Disease Backwards movement of gastric content GERD S&S – Heartburn – Sore throat – hoarsness

29. 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

30. Peptic Ulcer Disease (PUD) Break in the mucous lining of the stomach or duodenum where it comes in contact with gastric juice

31. PUD – S&S Pain – Burning, aching, unger- like – Relieved by eating – Heartburn Elderly – No symptoms

32. PUD - complications Hemorrhage – Hematemesis – Orthostatic hypotension – Occult stool – Fatigue, weak Obstruction – Feel full – N&V Perforation – Severe pain – No BS