2025-2026
Age related change - small intestine - Answers - Site of most absoprtion of nutrients
- atrophy of muscle and mucosal surface
- thinning of villi and epithelial cells
- results in decreased motility and transit time, which leads complaints of indigestion and
constipation
Age related change - oral - Answers - injury / loss or decay of teeth
- atrophy of taste buds
- decrease in saliva production
Age related change - Esophagus - Answers - decreased motility and emptying
- weakened gag relax
- decreased resting pressure of lower esophageal sphincter
- results in reflux and heartburn
Age related change - stomach - Answers - degeneration and atrophy of gastric mucosal surface
with decreased production of HCL
- decreased secretion of gastric acids and most digestive enzymes
- decreased gastric motility and emptying
- results in food intolerance , Malabsorption , or decreased vitamin B12 absorption
Age related change - large intestine - Answers - decreased mucus secretion
- decreased elasticity of rectal wall
- decreased tone of internal anal sphincter
- slower and duller nerve impulses in rectal area
- results in decreased motility and transit time , which leads to complaints of indigestion,
constipation , decreased absorption or nutrients such as dextrose fats , calcium , an iron and
fecal incontinence
physical examination - Answers Move from top to bottom
,General exam order - Answers Inspection , auscultation, percussion , Palpation
inspection - Answers - look! 👀
- chart if the abd is round , flat , distended. Do you see scars ? Stria? Wounds ?
Auscultation - Answers - listen! 👂
- done before palpation to avoid alternation of bowel sounds. Must chart if you hear absent ,
hypoactive, active , or hyperactive sounds.
percussion - Answers - tapping
- most nurses no longer do this
Palpation - Answers - feel 🖐
- chart if abd soft , firm , tender ?
Physical Exam: Abdomen - Answers - patient is placed supine with HOB slightly raised & knees
slightly flexed.
- RLQ , RUQ, LUQ , LLQ
physical examination: abdomen. (Inspection) - Answers - inspect skin or abd for color, texture,
scars, straie, rashes, lesions, & dilated blood vessels
- inspect the contour (flat, rounded, sunken-(someone who is cachexic), protuberant, or
distended.
- note location & contour of umbillicus
- aortic pulsations & peristalsis are sometimes observed in thin people.
physical examination: Abdomen (auscultating) - Answers - done before Palpation to prevent
altering bowel sounds.
- warm stethoscope & listen to all 4 quads
- normal BS (clicks & gurgles) occur 5-30 times per minute.
- if no BS are heard, listen for 5 full minutes before recording that BS are absent.
- auscultation is used to determine the character, location , and frequency of bowl sounds.
Physical examination: abdomen (Palpation & percussion) - Answers - Palpation performed
routinely to assess for tenderness & distention
- percussion is tapping on the skin to detect presence of air, fluid , or masses.
, computed tomography (CT) & magnetic resonance imaging (MRI) - Answers - both scans
provide cross - sectional images of organs and structures.
- painless but radiation doses are considerable
- May be performed with or without contrast (iv or oral)
CT & MRI - Answers - CT is usually faster in emergencies and MRI can visualize and differentiate
structures more than a CT. MRI uses magnets so not safe for all patients such as those with
pacemakers , dental implants , and skin patches, etc.
- ANY PATIENT WITH A SHELLFISH ALLERGY OR IODINE ALLERGY MUST BE SCREENED
BEFORE RECEIVING CONTRAST. Patient may be pre-medicated before receiving contrast or not
receive it at all depending on severity of allergy
barium swallow (upper GI series) - Answers - examination of the upper GI tract under the
fluoroscopy after the patient drinks barium sulfate in order to detect disorders of organs and
sphincters such as ulcers, varices, tumors, enteritis, obstructions, diverticula, etc.
- Patient is awake during this procedure
- Nursing interventions: NPO from midnight to night before the study, advise not to smoke or
chew gum during NPO period, bowel cleansing agent, monitor bowel movements for evacuation
of barium.
barium enema - Answers - used to detect the presence of polyps, tumors , or other lesions of
the large intestine and demonstrate any anatomic abnormalities or malfunctioning of the bowel.
- a fluoroscope & radiographic examination of the large intestine after rectal instillation of
barium sulfate.
- may be done with or without air ( air contrast)
- series of pictures can be done up to 24 hours.
- if patient has active inflammatory disease. Perforation, or active bleeding enemas
contraindicated.
- any history of inflammation of bowel then no enema. ( GI bleed , bowel obstruction ,
inflammatory disease)
Diagnostic procedure: upper GI. EGD - Answers - esophagogastroduodenoscpy
- direct visualization of the esophagus, gastric, and duodenal mucosa through a lighted scope
- following sedation, an endoscope is passed down the esophagus to view the gastric wall,