NUR 222 Digestion/Gastrointestinal

NUR 222 Digestion/Gastrointestinal What are the structures of the GI tract? - Correct Answer--mouth -esophagus -stomach -small intestine -large intestine -rectum -anus What are the 3 components of the small intestine? - Correct Answer--duodenum -jejunum -ileum How long is the duodenum? - Correct Answer-8-11 inches long How long is the jejunum? - Correct Answer-8 feet long How long is the ileum? - Correct Answer-12 feet long What are the functions of the small intestine? - Correct Answer--carries chyme from the stomach to the large intestine -absorbs nutrients into the bloodstream -adds bile from the liver to help break down fats What turns stool brown? - Correct Answer-bile What is the primary organ of bowel elimination? - Correct Answer-large intestine What combines the small and large intestines? - Correct Answer-cecum What are the 4 components of the colon? - Correct Answer--ascending -transverse -descending -sigmoid Rectum - Correct Answer-distal portion where feces is stored which connects to the anus Anus - Correct Answer-opening of the rectum What are the functions of the large intestine? - Correct Answer--absorbs water, sodium, chloride -waste material stored until expelled -contains bacteria that break down waste products What moves chyme and gas through the intestine, causing bowel sounds? - Correct Answer-peristalsis What is normal transit time through the GI tract from the mouth to the anus? - Correct Answer-18 to 72 hours Where in the large intestine is feces stored? - Correct Answer-sigmoid colon Is defecation under voluntary or involuntary control? - Correct Answer-voluntary What is the Valsalva maneuver and what is it used for? - Correct Answer--it is the bearing down maneuver that increases intraabdominal pressure -used to pass down How many sphincters does the anus have? - Correct Answer-2. An internal (involuntary) and an external (voluntary) sphincter. What is the speculated reason for our bodies having an appendix? - Correct Answer-it may have been necessary for consuming raw meat What is rebound tenderness used to check? - Correct Answer-appendicitis What are GI changes associated with aging?**** - Correct Answer--gastric mucosa atrophy -decreased peristalsis -dulled nerve impulses -distention and dilation of pancreatic ducts -decrease in number and size of hepatic cells -disruption of microbial balance of good anaerobic and aerobic flora What are factors that affect bowel elimination? - Correct Answer--age -diet -fluid intake -physical activity -psychological factors -personal habits -positioning -pain -pregnancy -surgery -medications -diagnostic tests What does a breastfed baby's stool look like? - Correct Answer-yellow, cottage cheese look What does a bottle-fed baby's stool look like? - Correct Answer-brown, more formed What are common bowel elimination problems? - Correct Answer--constipation -impacted (unrelieved constipation) -diarrhea -incontinence (usually CDIFF) -flatulence -hemorrhoids (varicose veins in rectal mucosa) What is an indicator of impaction? - Correct Answer-seeping diarrhea out of anus, usually with a fever What are different types of ostomies? - Correct Answer--ileostomy -colostomy What is effluent? - Correct Answer-stool that comes out of an ostomy What determines the softness/hardness of stool of an ostomy (effluent)? - Correct Answer-the placement of the ostomy What color should stomas appear? - Correct Answer-Beefy red What are some fecal characteristics? - Correct Answer-Color, odor, consistency, frequency, shape, constituents What colors can stool be? - Correct Answer-white, clay, black, tarry, red, pale, oily What consistencies can stool be? - Correct Answer-liquid, hard, soft, formed What shapes can stool be? - Correct Answer-narrow, ribbon/pencil What constituents can be in stool? - Correct Answer-blood, pus, foreign bodies, mucus, worms, oily stool What does white or clay colored stool indicate? - Correct Answer-lack of/problems with bile What is melena? - Correct Answer-a black, tarry stool indicating a GI bleed If you take iron or pepto bismol, what can happen to your stool? - Correct Answer-turn black What does red stool indicate? - Correct Answer-lower GI bleed What does pale or oily stool indicate? - Correct Answer-absorption problems What does ribbon/pencil shaped stool indicate? - Correct Answer-impaction or increased peristalsis In what order do you assess the abdomen? - Correct Answer-Inspect, Auscultate, Percuss, Palpate Why do you auscultate the abdomen first? - Correct Answer-because percussion and palpation can increase peristalsis, which would give a false interpretation of bowel sounds What organ are CBC and amylase/lipase serum tests associated with? - Correct Answer-pancreas What organ are ALT/AST serum tests associates with? - Correct Answer-liver How can losing blood in the bowels be detected? - Correct Answer-with a complete blood count (CBC) What does a purple occult blood test indicate? - Correct Answer-positive Which scope is used to check the small intestine? - Correct Answer-small bowel capsule endoscopy (enteroscopy) What are nursing diagnoses associated with bowel elimination? - Correct Answer--bowel incontinence -constipation -risk for constipation -diarrhea -lack of knowledge of dietary regimen What are examples of emetics/antiemetics? - Correct Answer--ipecac (emetic) -zofran -compazine What are examples of cathartics and laxatives? - Correct Answer--dulcolax -peri-colace -ex-lax -senokot What is an example of an antidiarrheal? - Correct Answer-immodium What are examples of laxatives/stool softeners? - Correct Answer--colace -dialose What are the different types of cleansing enemas? - Correct Answer--tap water (hypotonic) -normal saline (isotonic) -hypertonic solutions (fleets) -soapsuds (hypertonic) What is the safest type of enema? - Correct Answer-normal saline When are hypertonic enemas contraindicated? - Correct Answer-infants and people that are dehydrated Which enema irritates the bowel's mucous lining? - Correct Answer-soapsuds enema (maybe also the most common enema according to McFann?) What does an oil retention enema do? - Correct Answer-lubricates/softens stool What is a carminative enema? - Correct Answer-enema for gas relief What is a Kayexalate enema? - Correct Answer-enema used to remove K+ in pts with too much potassium How are enemas administered? - Correct Answer--clean, NOT sterile, technique -wear gloves -explain procedure, positioning, how to avoid discomfort, and how long to retain solution before defecation What position are enemas given in? - Correct Answer-side-lying or Sims position What is digital removal of stool? - Correct Answer-using your finger to remove stool if enemas fail to remove an impaction LAST RESORT in managing severe constipation What should you do if performing digital removal? - Correct Answer--monitor vital signs -be gentle so you do NOT stimulate the vagus nerve (can cause pt to pass out) What are the categories of NG tubes? - Correct Answer-fine/small bore and large bore What are fine/small bore NG tubes used for? - Correct Answer-medication administration and enteral feedings What are large bore (12-French and above) NG tubes used for? - Correct Answer-gastric decompression or removal of gastric secretions What technique is used to administer NG tubes? - Correct Answer-clean technique (not sterile) What are the purposes of NG tubes? - Correct Answer--decompression -enteral feeding -compression -lavage Decompression - Correct Answer-removal of secretions salem sump, levine Enteral feeding - Correct Answer-feeding purposes or to instill liquid dobhoff, levine Compression - Correct Answer-internal pressure by inflated balloon (GI bleeding, esophageal varices) sengstaken, blakemore tube Lavage - Correct Answer-stomach irrigation for active bleeding, poisoning, or gastric dilation levine, ewald, salem sump When is bowel training/retraining typically done? - Correct Answer-if someone has a spinal cord injury or fecal incontinence What can occur if a patient has cardiac disease or is taking cardiac/hypertensive medication and their vagus nerve is stimulated? - Correct Answer-sudden decrease in pulse rate nurse should obtain pulse rate prior to manipulating rectal tissue What is the vagus nerve responsible for? - Correct Answer-digestion, heart rate, respiratory rate, and coughing, sneezing, swallowing reflexes Vagal down (vasovagal syncope) - Correct Answer-sudden drop in heart rate and blood pressure