| 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 |
| what are the three major sections of the small intestine | duodenum, jejunum, and ileum |
| where does 90% of digestion take place | in the small intestine |
| 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 |
| _________ is the largest glandular organ in the body | liver |
| the ______ can store ____-____ mL of bile | gallbladder; 30,50 |
| after an endoscopy the pt will not be allowed to __ or ____ until the _____ returns | eat, drink, gag reflux |
| how can you assess if the pt gag reflux has returned | placing a tongue blade to the back of the pharynx |
| how does the hypothalamus( a portion of the brain) that contains two appetite centers affect eating | center stimulates to eat, other signal to stop eating |
| define lumen | the cavity or channel within a tube or tubular organ |
| occult blood | it is obscure or hidden away from view |
| when obtaining a stool specimen, the pt is instructed to keep the stool specimen free of ____ or _____ because either can _______ | urine, toilet paper, alter the test results |
| a pt should not eat _____ 24-48 hr before a ____ test | organ meat, guaiac |
| after a lower GI endoscopy exam; observe the pt for evidence of bowel perforation which include what symptoms | abdominal pain, tenderness, distention, and bleeding |
| 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 |
| ____ ____ is an ____ process that results from the action of bacteria on carbohydrates in the mouth, which in turn _______ | dental decay; produces acids that that dissolve tooth enamel |
| 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 two most common peptic ulcers are ___ and ___ | gastric, duodenal |
| 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 |
| ____ is considered the most lethal complication of peptic ulcers | perforation |
| 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 |
| if a to has a hernia how do you prevent a anaerobic infection in the area | immediate surgical intervention is performed |
| 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) |
| __ the discoloration of body tissue caused by abnormally high levels of ___, is visible when the total serum ___ exceeds __mg/dL | jaundice, bilirubin, 2.5 |
| 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 |
| define sclerotherapy | the injection of chemicals used to cause inflammation, followed by fibrosis and destruction of the vessels causing the bleeding |
| define hepatic encephalopathy | a type of brain damage caused by liver disease and consequent ammonia intoxication |
| define asterixis | a hand-flapping tremor in which the pt stretches out an arm and hyperextends the wrist with the fingers separated, relaxed, and extended |
| primary liver cancer patho | most frequently is heptocellular carcinoma; the other primary tumors are cholangiomas or biliary duct with carcinoma. |
| ___of the liver and an infection with ___ or ____ are high-risk factors for primary liver cancer | chirrosis, hepatitis c, hepatitis b |
| the __,__,__,__ and lung are common primary sites of cancer that ____ to the ___. | pancreas, colon, stomach, breast; metastasizes |
| hepatitis A is spread by | direct contact of the oral-fecal route, usually by food or water contaminated with feces |
| hepatitis B is spread by | contaminated serum via blood transfusion, contaminated needles and instruments, needle sticks, illicit intravenous(IV) drug use, and direct contact with body fluids from infected people, such as breast milk and sexual contact |
| hepatitis C is spread by | needle sticks, blood transfusions, illicit IV drug use, and unidentified mean, blood borne exposures |
| hepatitis E is spread by | oral-fecal route; it spreads through the fecal contamination water |
| pain resulting from cholecystitis or cholelithiasis sometimes are mistaken for | cardiac problems because of the pain that is felt in the epigastric region and radiating to the back |
| define flatulence | excess formation of gases in the stomach or intestine |
| define steatorrhea | excessive fats in the stool |
| what is the surgical procedure for gall stone retrieval | laparoscopic cholecystectomy & open abdominal cholecystectomy |
| post op nursing intervention for laparoscopic cholecystectomy | splint the abdomen with the hands, small pillow, or rolled bath blanket before attempting a cough |
| as the body ages the liver also has | decreased ability to regenerate after injury or from hepatotoxic injury |
| what factors are most common for pancreatitis | biliary tract disease and alcoholism |
| define occlusion | an obstruction or closing off |
| although once considered rare , ___ ___ is now the fourth leading cause of ___ death in the US and Canada | pancreatic cancer; cancer |
| the major factor in the high death rate from pancreatic cancer is | the difficulty in diagnosing it at an early, curable stage |
| the most common environmental risk factor for pancreatic cancer is | smoking seen in 30% of pt diagnosed with the disease |
| the digestive tract or alignment canal, is a muscular tube containing a mucous membrane lining that extends | from the mouth to the anus; approximately 9m (30 ft) long |
| the digest system includes | mouth, pharynx, esophagus, stomach, small intestine, large intestine, and anus |
