chapter 32 gastroenterology

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What is the primary function of the stomach?

Producing bile

Absorbing water

Transporting nutrients to the large intestine

Completing digestion slowly containing hydrochloric acid killing microorganisms to facilitate gastric enzyme activation-gastric juice is released at sight of smell of food (correct)

Which part of the GI tract contains three pairs of salivary glands?

Esophagus

Liver

Oral cavity- consisting of teeth, tongue and openings for salivary glands (correct)

Small intestine

What is the function of the pyloric sphincter? its made of smooth muscle at base of stomach

Absorbing nutrients

Producing bile

Killing microorganisms

it contracts to allow for small amounts of chyme to pass into the doudenum by regulating the rate of stomach emptying into small intestine (correct)

Which enzyme is produced in the mouth for digestion?

Amylase&linguinal lipase with water to mositen soften food Signup and view all the answers

Where does most absorption of water, vitamins, and minerals take place in the GI tract?

Large intestine known as the colon that extends from ileum of small intestine to anus, no digestion takes place here Signup and view all the answers

What is the main role of villi in the small intestine?

allows for more Absorption of nutrients Signup and view all the answers

Which organ carries bilirubin and excess cholesterol to the intestines?

Liver-located in right upper quadrant Signup and view all the answers

Which part of the GI tract completes digestion?

Small intestine-has excessive folds because more surface area is reuired for absorption Signup and view all the answers

What is the function of hydrochloric acid in the stomach?

Killing microorganisms Signup and view all the answers

What is the main role of the ileocecal valve?

Preventing backflow of fecal material from large intestine into small intestine Signup and view all the answers

What is the function of the cystic duct in conjunction with the common bile duct?

Combining with a left and right hepatic duct from the liver to form the common bile duct thats connected with the gallbladder Signup and view all the answers

How does the hepatic portal vein differ from the hepatic artery in terms of blood supply to the liver?

Hepatic portal vein brings blood high in nutrients but low in oxygen, while hepatic artery brings oxygenated blood. Signup and view all the answers

What happens to bile by-products filtered out by the liver after entering the bile or blood?

They are excreted into the intestines and leave the body in stool/blood by-products are filtered out by the kidneys and leave the body as urine Signup and view all the answers

How does bile by-products differ from blood by-products in terms of elimination from the body?

Bile by-products enter the intestine and leave in stool, while blood by-products are filtered out by the kidneys and excreted in urine Signup and view all the answers

Which vessel is responsible for carrying all blood that leaves the liver?

Hepatic vein Signup and view all the answers

What is the role of the hepatic portal circulation in allowing the liver to regulate blood levels of nutrients?

It permits the liver to process nutrient-rich blood before it reaches systemic circulation Signup and view all the answers

What is the function of the hepatic portal circulation in relation to harmful substances?

It enables removal of harmful substances by the liver before they circulate throughout the body Signup and view all the answers

What is significant about the hepatic portal vein's role in delivering blood to the liver?

It delivers nutrient-rich but oxygen-poor blood to be processed by the liver Signup and view all the answers

How does bile aid in excreting waste substances from the body?

It excretes waste substances into intestines for removal through stool Signup and view all the answers

What is the primary purpose of an Upper GI Series (Barium Swallow) procedure?

To examine the esophagus, stomach, duodenum, and jejunum by drinking a contrast medium by detecting strictures, ulcers, tumors, polyps, hital hernias, and motility issues, must be NPO six hours before procedure or smoking Signup and view all the answers

Which test requires the patient to drink an oral liquid radiopaque contrast medium?

Upper GI Series (Barium Swallow) Signup and view all the answers

What dietary restrictions are typically recommended before a Lower GI Series (Barium Enema)?

Low residue or clear liquid diet for several days-24 hours clear liquids and NPO 8 hours before the test, laxatives may be given day prior Signup and view all the answers

Which test involves visualizing the esophagus, stomach, and duodenum? It is used for diagnosing ulcers, cancer bleeding, specimens can be obtained as well

Esophagogastroduodenoscopy (EGD)-uses conscious sedation(versed), NPO 8 hours prior. Monitor the pateints gag reflex after, NPO until gag reflex returns, patient may have a sore throat for a few days, monitor for pain, fever, abnormal vital signs and bleeding Signup and view all the answers

Before an Esophagogastroduodenoscopy (EGD), what should the patient be prepared for?

NPO for 8 hours Signup and view all the answers

What is a possible consequence if a patient doesn't clear their bowel before a Lower GI Series?

Cancellation of the test due to low-quality images, post procedure give fluids, laxatives, monitor constipation, abdominal pain, rectal bleeding Signup and view all the answers

What is one potential post-procedure complication of an Upper GI Series involving barium use?

Stool obstruction leading to constipation-stools appear chalky white, educate pateint to increase fluids to clear barium, monitor for distention constipation Signup and view all the answers

What role does conscious sedation typically play in an Esophagogastroduodenoscopy procedure?

To minimize gag reflex and discomfort during the test Signup and view all the answers

Why is it important for patients undergoing diagnostic testing to follow dietary restrictions as advised?

To ensure accurate test results and interpretation Signup and view all the answers

What are the functions of the liver Kupffer's cells?

Removal of bacteria and foreign particles in portal blood Signup and view all the answers

Which substance is the end product of the breakdown of hemoglobin?

Bilirubin-found in liver, excess bilirubin is excreted as part of bile Signup and view all the answers

What is the role of the liver regarding vitamin storage?

Storage of both water-soluble vitamin b-12 and fat-soluble vitamins A, D, E, and K Signup and view all the answers

Which organ helps in converting harmful substances into less toxic ones?

Liver- by detoxifacation like converting ammonia into a less toxic substance known as urea. also alcohol and medications Signup and view all the answers

What is the function of gallbladder in digestion?

stores and concentrates biles, when there is fatty foods that need digestion in small intestine cholecystokinin is secreted to send signals to the gallbladder to contract and force bile in cystic duct and common bile to doudenum Signup and view all the answers

Which process occurs to excess bilirubin in the body?

It is excreted as part of bile Signup and view all the answers

What does the liver do to ammonia to make it less toxic?

Converts it to urea Signup and view all the answers

How does the gallbladder assist in digestion?

Stores and concentrates bile Signup and view all the answers

In what form does most iron get stored in the body?

As ferritin in the liver Signup and view all the answers

What is the primary function of activated vitamin D in the body?

Enhanced calcium absorption Signup and view all the answers

What is a common geriatric consideration related to the gastrointestinal system?

decreased secretion in the GI tract, loss of taste, teeth, peristalsis leads to constipation, indegestion, peridontal disease more common, diverticula may form, hemorrhoids may be more of a problem, risk of colon and oral cancer increase Signup and view all the answers

During a nursing assessment regarding nutritional assessment, what aspect would be important to evaluate?

Family history, cultural factors, nutriotonal assessment, medications, health history, Signup and view all the answers

What is the purpose of the pancreas(six inches long) secreting sodium bicarbonate?

To neutralize stomach acid,To assist in protein digestion with amylase, lipase, trypsinogen Signup and view all the answers

In a physical exam, what might a high-pitched tinkling sound during abdominal auscultation indicate?

Intestinal obstruction/. soft clicks and gurgles are normal/. absent sounds distal to obstruction Signup and view all the answers

What is the significance of a BMI of 30 or higher according to the text?

Considered obese-40 or higher is morbidly obese Signup and view all the answers

Which enzyme is responsible for breaking down carbohydrates in the pancreas?

Amylase Signup and view all the answers

What might be a common concern for geriatric patients regarding their teeth?

Difficulty with chewing Signup and view all the answers

What is the main function of lipase in digestion?

Aid in fat digestion Signup and view all the answers

How does BMI 40 or higher impact an individual's health?

Classified as morbidly obese Signup and view all the answers

What does a rapid or increased bowel sound frequency indicate?

Enhanced peristalsis maybe hungry or gastroenteritis <5 seconds Signup and view all the answers

What is the purpose of Endoscopic Retrograde Cholangiopancreatography (ERCP)?

To visualize the liver, gallbladder, and pancreas, bilary ducts, placed through mouth into stomach and doudenum Signup and view all the answers

During a Colonoscopy, what is the reason for the patient to be on a clear liquid diet the evening prior to the procedure?

To ensure the bowel is clear for a successful procedure, monitor for bleeding or severe pain after may expeirnce gas and abdominal cramping afterwards, bowel prep must be given prior to procedure Signup and view all the answers

What is the primary purpose of Liver Biopsy?

used when other diagnostic test have not been successful in diagnosing liver disease, risk for bleeding and may have diffucluty clotting in pateints with liver disease, lie on right side for 2 hours for branching to provide for pressure and decrease bleedingTo identify liver diseases like cancer and cirrhosis Signup and view all the answers

In Gastrointestinal Tubes, what is the reason for always checking the patency of the tube?(goes into stomach)(orogastric-mouth)(ng-tube is nose)

To maintain tube functionality and prevent complications, GI tube placing includes decompression, gastric secretion analysis, to releive and treat bleeding in GI, to provide nutrition or hydration Signup and view all the answers

What does placement of a Gastrointestinal Decompression tube achieve?

Relieve and treat obstruction in the GI tract Signup and view all the answers

What is the significance of bedrest after a Liver Biopsy?

To minimize risk of bleeding due to liver vascularity/provide pressure and decrease bleeding Signup and view all the answers

What is the primary indication for Gastrointestinal Tube placement?

Obtain gastric secretions for analysis Signup and view all the answers

Why is it important to maintain patency in a Gastrointestinal Tube?

To avoid complications and maintain tube functionality Signup and view all the answers

What is a common purpose of Gastrointestinal Decompression?

decompression happens when stomach or small intestine becomes filled with air of fluid can happen after major abdominal surgeryRelieve gastric or intestinal distention Signup and view all the answers

What does an NG (Nasogastric) Tube inserted through the nostril typically signify?

Short-term use for decompression or drainage purposes Signup and view all the answers

What is a common reason for using Enteral Nutrition?

To provide hydration and nutrition when unable to eat orally like a peg tubedirectly into GI tract, used when inability to swallow, trauma, burns, esophageal cancer, varices, burns of face and chest, often used after GI surgery Signup and view all the answers

In Enteral Feeding, what is a potential sign that the feedings are not being absorbed?

Abdominal distention, patient reports feeling full, nausea, vomitting, feeding should be stopped to prevent aspiration Signup and view all the answers

Why is gravity feeding a method used in Enteral Feeding?

To ensure a slow delivery of nutrients Signup and view all the answers

What is a typical indication for using Jejunostomy in Enteral Nutrition?

Severe burns on the chest Signup and view all the answers

How can Enteral Feeding help prevent dehydration in patients?

By ensuring adequate fluid intake Signup and view all the answers

What is a common purpose of using Continuous Feeding in Enteral Nutrition?

To provide a steady nutrient supply over 24 hours Signup and view all the answers

Why should Enteral Feeding be monitored closely for signs of non-absorption?

To prevent aspiration and ensure effective nutrition delivery Signup and view all the answers

What is a potential complication that a patient undergoing Parenteral Nutrition (PN) (IV) may face, requiring blood glucose monitoring and potential insulin therapy?

Hyperglycemia Signup and view all the answers

When administering Parenteral Nutrition (PN) via an IV route, which nutrients are typically included in the PN solution?

Fats and electrolytes, protein, minerals, vitamins, trace elemtents. PN has a high concentration of glucose Signup and view all the answers

What is the primary difference between enteral nutrition and parenteral nutrition?

Enteral nutrition is delivered through the digestive system, while parenteral nutrition bypasses the digestive system. Signup and view all the answers

Why is it important to check the pH of gastric aspirate in patients receiving enteral feeding?

To confirm tube placement in the stomach Signup and view all the answers

Which method is commonly used to initially confirm the placement of a feeding tube before relying on pH checks in enteral feeding procedures?

X-ray imaging Signup and view all the answers

What is the primary purpose of using normal saline for irrigation in enteral feeding procedures?

To reduce the risk of infection Signup and view all the answers

In enteral feeding, what would be a common concern associated with using liquid medications that need to be crushed for administration?

Interference with tube absorption Signup and view all the answers

How do reference ranges help clinicians in interpreting test outcomes?

By identifying potential issues and guiding further diagnostic processes Signup and view all the answers

What is one of the primary methods used to establish lab test reference ranges?

Indirect estimation using stored test results Signup and view all the answers

How do calibrators and controls contribute to reducing variability in lab test results?

By ensuring consistency across different testing equipment Signup and view all the answers

Why might reference ranges sometimes be defined based on clinical outcomes instead of statistical analysis alone?

To predict potential outcomes rather than relying solely on numbers Signup and view all the answers

What is the main benefit of conducting centralized comparative performance monitoring regularly?

To maintain accuracy and consistency in lab testing Signup and view all the answers

What are norm lab results

Ammonia- 10-80 mcg/dL  Potassium- 3.5-5.0  Amylase- 60-120 units/L  Lipase- 0-160 units/ Signup and view all the answers

Lab values that are normal

Bilirubin level- Less than 1.0 mg/dL  Occult blood: Should be negative  Alt- 4-36 units/L varies by age  AST- 0-35 units/L- also varies by ag Signup and view all the answers