1. Digestive System

2. Structure

3. Abdominal Quadrants

4. Abdominal Regions

5. Mouth where the digestive process begins
consists of the tongue, salivary glands, teeth, and pharynx

6. Esophagus
A tube 10 to 12 inches long that carries food from the mouth to the stomach

7. Stomach a hollow, muscular, J-shaped organ
holds food from 3 to 4 hours
has three parts: the fundus, body, and pylorus
produces gastric juices that help break down food

8. Intestines
the small intestine: where most of the food the body needs are absorbed into the bloodstream
the large intestine: where most water is absorbed, wastes are changed into solid form

9. Appendix
function is not known
attached to the cecum

10. Liver The largest gland in the body
helps control the amount of protein and sugar in the body by changing and storing excess amounts

11. Gallbladder
a small hollow sac that is attached to the underside of the liver
it releases bile from the liver into the small intestine to help digest a fatty meal

12. Pancreas located behind the stomach aids in the digestion of food
produces insulin

13. Common Conditions of the Digestive System

14. Malignancies very common symptoms depend on location indigestion
vomiting
constipation
obstruction
bloody stool

15. Ulcerations a sore or tissue breakdown
common places: colon, stomach, duodenum

16. Hernias
the intestine pushes through a weakened area of the abdominal wall

17. Gallbladder Conditions
cholecystitis: inflammation of the gallbladder
cholelithiasis: formation of stones in the gallbladder

18. Common Problems Related to the Lower Bowel
diarrhea: multiple watery stools
constipation: when stool passes through the colon too slowly – most severe form: fecal impaction
bowel incontinence: involuntary passage of fecal material from the anus

19. Procedures Related to the Digestive System

20. Nasogastric Tube

21. NG Tube cont.
may be placed for stomach decompression (ex. – during CPR)
to give stomach rest
to relieve nausea

22. Normal CT of Abd

23. CT Scans
CTs may be done of abd/pelvis, with or without contrast (IV or PO)
used to diagnose abnormalities/conditions of digestive system

24. Esophagogastroduodenoscopy (EGD)
May be used to diagnose problems of the esophagus, stomach or duodenum
May be done in GI Lab at a Hospital as an outpatient

25. Nutrition
Food & fluids contain Nutrients-a substance the is taken in , digested, absorbed, and used by the body
Grouped into fats, proteins, carbohydrates, vitamins, minerals, and water (FPCVMW)
Which nutrients give the body fuel for energy?
FPC
Energy measured in calories
Food guide pyramid helps to guide healthy food choices-has 4 levels

26. Nutrients Essential nutrients come from many different foods
Refer to basic information sheet about nutrition
Sometimes special diets needed to manage nutrition in patients

27. Fluid Balance Water needed to live
Death can occur if there is too little or too much
Water is taken in through food and fluids
Water lost through elimination of urine and feces also through vomiting, perspiration and exhaling
To be healthy fluid balance is needed
Fluid taken in (intake) and lost (output) needs to be equal
Swelling (edema) occurs when more is taken in than put out
Dehydration occurs when more fluid is put out than taken in

28. Fluid Balance Adults need to take in 1500 ml per day
For normal fluid balance about ml is needed per day
Normal person can take fluid orally
Sometimes patients require special orders for fluids
Fluids may need to be encouraged to increase intake
Fluids may be restricted to a certain amount per day

29. Enteral Nutrition-Tubes
Nutrition given by gavage (tube feeding)
Different types of tubes
Nasogastric (NG) -inserted through the nose
Gastrostomy- inserted into the stomach through a surgically created opening
Jejunostomy – inserted in to small intestines through surgically created openint
Percutaneous endoscopic gastroostomy (PEG) Tube- inserted into the stomach with an endoscope and through a puncture wound made through the skin into the stomach

30. Enteral Nutrition-Formula
Formula ordered by doctor
Most contain all of the nutrients
Sometime may be made by the dietary department
Feedings may be continuous or scheduled at intervals
If they are continuous a pump is used to give the feeding
Scheduled feedings may be given with a syringe or tube feeding bag that allows feeding to drip

31. Enteral Feeding- Observations
Major risk is aspiration –which is breathing in of fluid or an object into the lungs
Aspiration can cause pneumonia and death
It is important to take measures to prevent aspiration
Nurse must regularly make sure tube is in the right place because tubes can move from coughing and sneezing or vomiting

32. Tube Feeding-Preventing Aspiration
X-ray may be taken after tube is inserted to verify placement
Nurse may check tube placement by aspirating gastric secretions
Prevent regurgetation by positioning patient in semi-Fowler’s Position –ask nurse of check care plan to find our how long
If there is a delay in stomach emptying can regurgitate feeding
Avoid left side lying position
Less of a problem with
J-Tube

33. Observations for Patients receiving Tube Feedings
Observe and report immediately to nurse:
Nausea, vomiting
Diarrhea
Discomfort during tube feeding
Enlarged or swollen stomach
Elevated temperature
Redness, swelling, drainage
odor or pain at the insertion site
Difficulty breathing
Elevated pulse rate
Coughiing
Complaints of bloating or flatulence

34. Intravenous Therapy
This is giving fluids by way of a needle or catheter that has been inserted into a patient’s vein usually by an RN
May be given in various settings such as hospital, outpatient, doctor’s office, home care setting, long-term care setting
Requires a doctor’s order
Given to replace fluids, replace vitamins and minerals lost from illness or injury
Blood and blood products are given through IV

35. Intravenous Therapy Sites
Peripheral Sites- away from the center of the body
Sites may be in the hand, wrist, and antecubital space ( bend of elbow)
If site is an IV catheter or needle facility may allow PCT to discontinue
PCT must know how and have been delegated this responsibility by the RN before attempting to D/C an IV.
Central Venous

36. TPN
Provides total parenteral nutrition (TPN) also called Hyperalimentation to patients.
May be given through aperipheral
TPN contains all of the essential nutrients needed to sustain life, Fat may be added in the form of lipids

37. Specimen Collection Principles
Adhere to medical asepsis principles
Follow Standard Precautions
Use a clean or sterile container for each specimen
Use the right container for the specimen
Label the specimen correctly
Avoid touching the inside of the container and lid
Urine must be free of feces
No tissue in urine and stool specimen
Place specimen in plastic bag
Specimen should be taken to lab promptly