NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
layers:
i. Mucosa – innermost layer / layer of smooth muscle and
1. Gastrointestin
specialized exocrine gland cells
al System
ii. Submucosa – surrounds mucosa / made up of connective
A. Review
tissue
Anatomy
iii. Muscularis—composed of both circular and
and
longitudinal smooth muscles, keeps contents
Physiology
moving through the tract
a. Runs
iv. Serosa – composed of connective tissue
from
c. The GI Tract (muscular alimentary canal)
the
i. Mouth, pharynx, esophagus, stomach, small intestine, large
mou
intestine, anus
th
d. The accessory digestive organs—supplies secretions
anus
contributing to the breakdown of food
,
i. Teeth & tongue, salivary glands, gallbladder, liver,
abou
pancreas
t 25
e. Function – secretion, digestion, absorption, motility, and
feet
ELIMINATION
in
i. Foods and fluids are ingested, swallowed, and propelled
leng
along the lumen of the GI tract to the anus for
th
elimination
b. Stru
1. Moved by smooth muscle contractions
ctur
ii. Digestion is the mechanical breakdown of food to be used
e—
by the body
four
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
,NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
1. bsorbed for use of the body
B. Nursing Assessment
a. ABDOMINAL ASSESSMENT: Ask the patient to empty bladder
then lie supine. If there is an area of abdominal pain or
discomfort, that area will be assessed last. The assessment is
to proceed in the following order:
i. Inspection: Inspect the skin and note findings of
asymmetry, discoloration, scarring, distention, or taut
skin. Observe shape and contour.
ii. Auscultation: This is performed using the diaphragm of
the stethoscope because bowel sounds are usually high-
pitched. Note bowel sounds as hypoactive, normoactive,
or hyperactive. Normal frequency bowel sounds are in
the range of 5-30 per minute. Listen in each quadrant and
if there are no bowel sounds noted in a particular
quadrant, you must listen for a full 5 minutes to
determine if there are truly absent bowel sounds. The
most effective way to assess return of peristalsis after
surgery is to ask the patient if they have passed flatus.
iii. Percussion: This is usually done by the provider to
determine the size of solid organs; to detect presence of
masses, fluid and air. The liver and spleen can be
percussed. Enlargement of the liver is termed
hepatomegaly. Enlargement of the spleen is termed
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
,NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
s This is done to determine size and location of abdominal
p organs and to assess presence of masses or tenderness.
l Deep palpation should only be done by the provider.
e Light palpation can be done by the nurse to note any
n areas of tenderness or guarding.
o b. **Do not palpate any abdominal pulsating mass, as it could
m be a life-threatening abdominal aortic aneurysm (AAA)
e
g 1. Diagnostic Tests and Procedures – Nursing Management
a A. Laboratory Tests
l 1) Serum – CBC, AST, ALT
y a. Complete blood count (CBC): aids in the diagnosis of anemia
. and infection
iv. P i. Detects changes in the blood’s formed elements
a b. Aspartate aminotransferase (AST) and Alanine
l aminotransferase (ALT): two enzymes found in the liver
p and other organs
a i. These enzymes are elevated in most liver disorders,
t but they are highest in conditions that cause
i necrosis, such as severe viral hepatitis and cirrhosis
o c. Bilirubin: primary pigment in bile
n i. Important in the evaluation of jaundice and
: liver and biliary tact functioning
ii. Elevations in direct and indirect bilirubin levels
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
, NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
c amylase, urobilinogen
a a. Amylase: enzyme that converts starch and glycogen into
n simple sugars found most commonly in saliva and
in pancreatic fluids
di b. Urobilinogen: a form of bilirubin that is converted by
c the intestinal flora and excreted in the urine
a i. Evaluation of hepatic and biliary obstruction
t 3) Stool – fecal occult blood test (FOBT), ova and parasites, fecal fats,
e clostridium
i a. Fecal occult blood test (FOBT): checks for hidden blood in
m the stool
p i. Positive test indicates bleeding in the GI tract
ai ii. Pre-Diagnostic:
r 1. To prevent a false-positive result, certain foods
e and medications should be avoided prior to and
d during stool specimen collections on 2-3
s consecutive days.
e 2. The health care provider will go over
cr medications with the patient before the test
e and may instruct the patient to stop taking
ti certain medications 48 hours before the test.
o 3. Foods the patient will typically be instructed to
n avoid include red meat and poultry; and beets,
2) Urine – broccoli, cantaloupe, carrots, cauliflower,
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
layers:
i. Mucosa – innermost layer / layer of smooth muscle and
1. Gastrointestin
specialized exocrine gland cells
al System
ii. Submucosa – surrounds mucosa / made up of connective
A. Review
tissue
Anatomy
iii. Muscularis—composed of both circular and
and
longitudinal smooth muscles, keeps contents
Physiology
moving through the tract
a. Runs
iv. Serosa – composed of connective tissue
from
c. The GI Tract (muscular alimentary canal)
the
i. Mouth, pharynx, esophagus, stomach, small intestine, large
mou
intestine, anus
th
d. The accessory digestive organs—supplies secretions
anus
contributing to the breakdown of food
,
i. Teeth & tongue, salivary glands, gallbladder, liver,
abou
pancreas
t 25
e. Function – secretion, digestion, absorption, motility, and
feet
ELIMINATION
in
i. Foods and fluids are ingested, swallowed, and propelled
leng
along the lumen of the GI tract to the anus for
th
elimination
b. Stru
1. Moved by smooth muscle contractions
ctur
ii. Digestion is the mechanical breakdown of food to be used
e—
by the body
four
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
,NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
1. bsorbed for use of the body
B. Nursing Assessment
a. ABDOMINAL ASSESSMENT: Ask the patient to empty bladder
then lie supine. If there is an area of abdominal pain or
discomfort, that area will be assessed last. The assessment is
to proceed in the following order:
i. Inspection: Inspect the skin and note findings of
asymmetry, discoloration, scarring, distention, or taut
skin. Observe shape and contour.
ii. Auscultation: This is performed using the diaphragm of
the stethoscope because bowel sounds are usually high-
pitched. Note bowel sounds as hypoactive, normoactive,
or hyperactive. Normal frequency bowel sounds are in
the range of 5-30 per minute. Listen in each quadrant and
if there are no bowel sounds noted in a particular
quadrant, you must listen for a full 5 minutes to
determine if there are truly absent bowel sounds. The
most effective way to assess return of peristalsis after
surgery is to ask the patient if they have passed flatus.
iii. Percussion: This is usually done by the provider to
determine the size of solid organs; to detect presence of
masses, fluid and air. The liver and spleen can be
percussed. Enlargement of the liver is termed
hepatomegaly. Enlargement of the spleen is termed
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
,NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
s This is done to determine size and location of abdominal
p organs and to assess presence of masses or tenderness.
l Deep palpation should only be done by the provider.
e Light palpation can be done by the nurse to note any
n areas of tenderness or guarding.
o b. **Do not palpate any abdominal pulsating mass, as it could
m be a life-threatening abdominal aortic aneurysm (AAA)
e
g 1. Diagnostic Tests and Procedures – Nursing Management
a A. Laboratory Tests
l 1) Serum – CBC, AST, ALT
y a. Complete blood count (CBC): aids in the diagnosis of anemia
. and infection
iv. P i. Detects changes in the blood’s formed elements
a b. Aspartate aminotransferase (AST) and Alanine
l aminotransferase (ALT): two enzymes found in the liver
p and other organs
a i. These enzymes are elevated in most liver disorders,
t but they are highest in conditions that cause
i necrosis, such as severe viral hepatitis and cirrhosis
o c. Bilirubin: primary pigment in bile
n i. Important in the evaluation of jaundice and
: liver and biliary tact functioning
ii. Elevations in direct and indirect bilirubin levels
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
, NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
c amylase, urobilinogen
a a. Amylase: enzyme that converts starch and glycogen into
n simple sugars found most commonly in saliva and
in pancreatic fluids
di b. Urobilinogen: a form of bilirubin that is converted by
c the intestinal flora and excreted in the urine
a i. Evaluation of hepatic and biliary obstruction
t 3) Stool – fecal occult blood test (FOBT), ova and parasites, fecal fats,
e clostridium
i a. Fecal occult blood test (FOBT): checks for hidden blood in
m the stool
p i. Positive test indicates bleeding in the GI tract
ai ii. Pre-Diagnostic:
r 1. To prevent a false-positive result, certain foods
e and medications should be avoided prior to and
d during stool specimen collections on 2-3
s consecutive days.
e 2. The health care provider will go over
cr medications with the patient before the test
e and may instruct the patient to stop taking
ti certain medications 48 hours before the test.
o 3. Foods the patient will typically be instructed to
n avoid include red meat and poultry; and beets,
2) Urine – broccoli, cantaloupe, carrots, cauliflower,
NURS 304 BEST EXAM STUDY GUIDE-ADULT HEALTH NURSING 1
MODULE 9:GASTROINTESTINAL LATEST UPDATE 2022
