MED SURG NURS120L Exam 2 Review- West Coast University

2/2/202




1 Nutrition and Metabolism
• The Gastrointestinal System
• Nutritional Problems
• Upper GI Problems
• Lower GI Problems
• Diabetes Mellitus
•
2 Week 2 Objectives
Nutrition
Summarize the nursing process in care of the patient with alterations in nutrition.
Classify priorities in the care of patients with alterations in nutrition using the following applicable
concepts: oxygenation, nutrition, perfusion, fluid/electrolyte regulation, infection/inflammation,
tissue integrity, pain, metabolism, elimination, and safety.
Identify inter-professional collaboration/team management needs of the patient with alterations
in nutrition.
Examine the pharmacologic, nutritional, developmental, and teaching needs of the patient with
alterations in nutrition.


3 Topics Covered
Lewis Ch. 38: Assessment: Gastrointestinal System
Lewis Ch. 39: Nutritional Problems
Lewis Ch. 41: Upper Gastrointestinal Problems
Lewis Ch. 42: Lower Gastrointestinal Problems
Lewis Ch. 47: Assessment: Endocrine System
Lewis Ch. 48: Diabetes Mellitus
ATI Ch. 46: Gastrointestinal Diagnostic Procedures
ATI Ch. 47: Gastrointestinal Therapeutic Procedures
ATI Ch. 52: Inflammatory Bowel Disease
ATI Ch. 82: Diabetes Mellitus Management
ATI Ch. 83: Complications of Diabetes Mellitus


4 Gastrointestinal (Digestive) System
GI Tract
Mouth
Esophagus
Stomach
Small and Large Intestines
Rectum and Anus
Associated Organs
Liver
Pancreas
Gallbladder

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5 Functions
1 Mouth
Salivary amylase initiates digestion of starch
Stomach
Stores food, mixes it with secretions, empties boluses into small intestine
Small Intestine
Digestion and absorption
Pancreatic enzymes, bile
Large Intestine
Absorbs water and electrolytes
2 Liver
Largest internal organ
Makes bile for fat emulsification and digestion
Gallbladder
Concentrates and stores bile
Fat in duodenum causes contraction and release
Pancreas
Exocrine– produces and releases enzymes
Endocrine– releases insulin

6 Effects of Aging on GI System
1 Decreased Appetite
Tooth caries or loss
Decline in taste buds
Decreased sense of smell
Xerostomia
Constipation
Peristalsis slows
Inactivity
Decrease in fiber intake
Inadequate fluid intake
Constipating medications
2 Liver
Decreased ability to metabolize drugs
Gallbladder
Disease increases with age
Decreased Intake
Economic constraints
Immobility
7 ASSESSMENT OF GI SYSTEM
Subjective Data
Past Health History
Diseases: Reflux, Hepatitis, Gallstones, Peptic Ulcer, Diverticuli, Cancer
Symptoms: Vomiting, Diarrhea, Constipation, Indigestion, Rectal Bleeding

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Symptoms: Vomiting, Diarrhea, Constipation, Indigestion, Rectal Bleeding
Food Intolerances/Allergies
Weight History: Unexplained weight loss or gain in past year
Medications
Include OTC, herbs, vitamins
Side effects can cause harm to GI system
Surgery/Treatments
Abdominal or rectal surgery—year, reason, postoperative course
Hospitalizations for GI issues

8 ASSESSMENT OF GI SYSTEM
Subjective Data(cont.)
1 Health Practices
ETOH and smoking use
Family History
Nutritional Assessment
24 hour dietary recall
Elimination
Fluid and fiber intake
Changes in pattern
Activity
Ambulatory Status
Sleep
Symptoms can interfere with sleep
2 Sensory Alterations
Change in Taste or Smell
Hot or Cold Sensitivity
Self-Concept
Weight and Ostomies
Relationships
Chronic illness
Coping and Stress
Can cause GI symptoms
Values and Beliefs
Respect spiritual and cultural beliefs, if possible

9 ASSESSMENT OF GI SYSTEM
Objective Data
1 Mouth
Moist and pink lips and buccal mucosa
Tongue and uvula midline
Teeth in good repair
Swallows without cough or gag
Abdomen
Flat. No masses or bruising.