NUR 113 Ultimate Q&A Guide for Nursing Exam
Success
Enzymes of chewing and swallowing
saliva, salivary amylase
Enzymes of gastric function
hydrochloric acid, pepsin, intrinsic factor
Small intestine function enzymes
amylase, lipase, trypsin, bile
How does digestion begin
In the mouth with the chewing and mixing of nutrients with saliva
Chyme
mixture of enzymes and partially-digested food
How much food can the stomach hold?
On average 1500 mL
How long does it take for food to digest?
Depends on the person, taking minutes to hours
What are the functions of the digestive tract?
-Breakdown of food for digestion
-Absorption into the bloodstream of small nutrient molecules produced by digestion
-Elimination of undigested unabsorbed foodstuffs and other waste products
What is apart of the GI tract?
mouth, pharynx, esophagus, stomach, small and large intestine
Where is the stomach located?
LUQ
Esophagus
Hollow muscular tube that moves food boluses down with peristaltic movements
,GI history assessment
Demographics, family history, and genetic risk
Current health problems
Diet (alcohol, caffeine, etc,)
Physical and psychosocial (stress, anxiety)
Assess knowledge
Bowel/bladder habits and changes
Cultural questions provide insight to eating habits
Abdominal assessment
inspection, auscultation, percussion, palpation
Patient lays flat as possible
Measure weight
Measure abdominal girth
Listen to bowels in all 4 quadrants
Stomach changes in the elderly
Atrophy of gastric mucosa, decreased hydrochloric acid level. Decreased iron absorption.
Encourage bland food high in vitamins and assess for epigastric pain
Large intestine changes in elderly
Peristalsis decreases and nerve impulses dulled.
Possible consipation and impaction
Encourage activity, fiber, and fluids.
Most organs slow down in geriatrics except the ____
protstate
Liver function test
AST, ALT, ALP
Bilirubin
Albumin 3.5-5.7 g/dL
What does a liver function test present as with liver damage?
AST, ALT, ALP increased
bilirubin increase with liver damage, bile duct obstruction, or other hepatobiliary disorders.
Albumin decrease with hepatic disease
GI blood test examples
,Amylase elevated with pancreatitis
Lipase increase with pancreatitis
Alpha-fetoprotein increase in liver cancer, cirrhosis, heptatis
ammonia increase in liver disease
What happens when ammonia is elevated?
Neuro problems
Lactulose is used to eliminate ammonia, causing diarrhea,
Fecal Occult Blood Test
Stool sample taken and tested for hidden blood
Most common Hemocult2
Fecal occult blood test instructions
Instruct client to restrict anticoagulants, NSAIDS 7 days before test and apply dietary restrictions
48 hours until test. Restrictions include vit c enriched food, beets, red meat, horseradish etc.
No active hemorrhoids
Take a sample for three consecutive days
What diagnostic labs are normally preformed to assess GI function?
CBC, metabolic, stool samples, urinalysis (pancreatic)
liver panel (liver problem),
Urea breath test
Done to detect H.pylori bacteria in GI system.
If CO2 level is high after drinking solution, H pylori is present.
Urea breath test instructions
Client NPO 1 hour before test and stop taking any antacids, PPI, antimicrobials several weeks
before (anything to alter stomach)
Client breaths in bag to obtain baseline CO2 then client drinks special carbon enriched urea
solution and then asked to exhale into another special bag (collection container)
Esophageal Manometry
Recorder lower esophageal sphincter pressure and peristaltic activity of the esophagus
Used to diagnosed GERD
Shows if esophagus can handle food and problems swallowing
Esophageal Manometry Instructions
, -NPO before procedure
-Clients stop taking anticholinergics, pain meds, antacids, PPIs, h2 blockers before procedure
-tiny tube with multiple sensors will be passed through nose down to esophagus, where tube
exits the nose connected to a device that records video and plots the graph
-Pressure exerted by esophageal muscle at rest and with small sips of water is observed to plot
the graph to notice GI motility
Upper GI barium study
Series of xrays are ordered to examine integrity and patency of GI tract
Pt drinks liquid barium. Studies done to observe movement of contrast medium fluoroscope
Upper GI barium study prep
NPO
Client may be placed on low residue diet and/or clear liquid beforehand
No anticholinergics or narcotics before tests
Upper GI barium study post procedure care
-Eliminating barium with laxatives and drinking fluids.
-Stool will look white and chalky colored 24-27 hours after study.
- Assess gag reflex return before giving food
-Tell pt to report if abdomen is full, distended, in pain, or there is a delay for stool to be brown
Aspiration of barium swallow can cause severe _____ ____
aspiration pneumonia
Esophagogastroduodenoscopy (EGD)
-upper GI endoscopy: examine lining of esophagus, stomach, duodenum
-flexible fiber optic endoscope is inserted to visualize inflammations, ulcerations, tumors, and
may illustrate gastric motility
-used to evaluate bleeding, ulceration, inflammation, masses, tumors, and cancerous lesions or
therapeutic to dilate strictures and cauterize bleeding.
-provides definitive diagnosis for many GI diseases
EGD prep
NPO and remove dentures for bite block.
EGD care during surgery
-Conscious sedation used
-Local anesthetic used to inactive gag reflex and facilitate passage of tube
Success
Enzymes of chewing and swallowing
saliva, salivary amylase
Enzymes of gastric function
hydrochloric acid, pepsin, intrinsic factor
Small intestine function enzymes
amylase, lipase, trypsin, bile
How does digestion begin
In the mouth with the chewing and mixing of nutrients with saliva
Chyme
mixture of enzymes and partially-digested food
How much food can the stomach hold?
On average 1500 mL
How long does it take for food to digest?
Depends on the person, taking minutes to hours
What are the functions of the digestive tract?
-Breakdown of food for digestion
-Absorption into the bloodstream of small nutrient molecules produced by digestion
-Elimination of undigested unabsorbed foodstuffs and other waste products
What is apart of the GI tract?
mouth, pharynx, esophagus, stomach, small and large intestine
Where is the stomach located?
LUQ
Esophagus
Hollow muscular tube that moves food boluses down with peristaltic movements
,GI history assessment
Demographics, family history, and genetic risk
Current health problems
Diet (alcohol, caffeine, etc,)
Physical and psychosocial (stress, anxiety)
Assess knowledge
Bowel/bladder habits and changes
Cultural questions provide insight to eating habits
Abdominal assessment
inspection, auscultation, percussion, palpation
Patient lays flat as possible
Measure weight
Measure abdominal girth
Listen to bowels in all 4 quadrants
Stomach changes in the elderly
Atrophy of gastric mucosa, decreased hydrochloric acid level. Decreased iron absorption.
Encourage bland food high in vitamins and assess for epigastric pain
Large intestine changes in elderly
Peristalsis decreases and nerve impulses dulled.
Possible consipation and impaction
Encourage activity, fiber, and fluids.
Most organs slow down in geriatrics except the ____
protstate
Liver function test
AST, ALT, ALP
Bilirubin
Albumin 3.5-5.7 g/dL
What does a liver function test present as with liver damage?
AST, ALT, ALP increased
bilirubin increase with liver damage, bile duct obstruction, or other hepatobiliary disorders.
Albumin decrease with hepatic disease
GI blood test examples
,Amylase elevated with pancreatitis
Lipase increase with pancreatitis
Alpha-fetoprotein increase in liver cancer, cirrhosis, heptatis
ammonia increase in liver disease
What happens when ammonia is elevated?
Neuro problems
Lactulose is used to eliminate ammonia, causing diarrhea,
Fecal Occult Blood Test
Stool sample taken and tested for hidden blood
Most common Hemocult2
Fecal occult blood test instructions
Instruct client to restrict anticoagulants, NSAIDS 7 days before test and apply dietary restrictions
48 hours until test. Restrictions include vit c enriched food, beets, red meat, horseradish etc.
No active hemorrhoids
Take a sample for three consecutive days
What diagnostic labs are normally preformed to assess GI function?
CBC, metabolic, stool samples, urinalysis (pancreatic)
liver panel (liver problem),
Urea breath test
Done to detect H.pylori bacteria in GI system.
If CO2 level is high after drinking solution, H pylori is present.
Urea breath test instructions
Client NPO 1 hour before test and stop taking any antacids, PPI, antimicrobials several weeks
before (anything to alter stomach)
Client breaths in bag to obtain baseline CO2 then client drinks special carbon enriched urea
solution and then asked to exhale into another special bag (collection container)
Esophageal Manometry
Recorder lower esophageal sphincter pressure and peristaltic activity of the esophagus
Used to diagnosed GERD
Shows if esophagus can handle food and problems swallowing
Esophageal Manometry Instructions
, -NPO before procedure
-Clients stop taking anticholinergics, pain meds, antacids, PPIs, h2 blockers before procedure
-tiny tube with multiple sensors will be passed through nose down to esophagus, where tube
exits the nose connected to a device that records video and plots the graph
-Pressure exerted by esophageal muscle at rest and with small sips of water is observed to plot
the graph to notice GI motility
Upper GI barium study
Series of xrays are ordered to examine integrity and patency of GI tract
Pt drinks liquid barium. Studies done to observe movement of contrast medium fluoroscope
Upper GI barium study prep
NPO
Client may be placed on low residue diet and/or clear liquid beforehand
No anticholinergics or narcotics before tests
Upper GI barium study post procedure care
-Eliminating barium with laxatives and drinking fluids.
-Stool will look white and chalky colored 24-27 hours after study.
- Assess gag reflex return before giving food
-Tell pt to report if abdomen is full, distended, in pain, or there is a delay for stool to be brown
Aspiration of barium swallow can cause severe _____ ____
aspiration pneumonia
Esophagogastroduodenoscopy (EGD)
-upper GI endoscopy: examine lining of esophagus, stomach, duodenum
-flexible fiber optic endoscope is inserted to visualize inflammations, ulcerations, tumors, and
may illustrate gastric motility
-used to evaluate bleeding, ulceration, inflammation, masses, tumors, and cancerous lesions or
therapeutic to dilate strictures and cauterize bleeding.
-provides definitive diagnosis for many GI diseases
EGD prep
NPO and remove dentures for bite block.
EGD care during surgery
-Conscious sedation used
-Local anesthetic used to inactive gag reflex and facilitate passage of tube
