Digestive System Assessment Quiz

Digestive System Assessment

• Digestion refers to the breakdown of food into small particles for swallowing and mixing with digestive enzymes
• Absorption refers to the small intestine's primary function of absorbing nutrients and minerals into the bloodstream.
• Perforation is a life-threatening condition that requires immediate surgical intervention and antibiotics, resulting in excruciating retrosternal pain and dysphasia.
• X-ray, barium swallow, and chest CT are used to diagnose perforation.
• Patients who undergo perforation surgery are placed on a nil by mouth (NPO) post-op diet.

Hiatal Hernia

• The enlargement of the esophageal opening allows the upper stomach to move into the lower chest.
• Symptoms include dysphagia, pyrosis, regurgitation, intermittent epigastric pain, fullness after eating, and nausea/vomiting, though some patients may be asymptomatic.
• X-ray studies, barium swallow, EGD, esophageal manometry, and CT are used for diagnosis.
• Medical management is used to treat symptomatic patients, and surgery (typically laparoscopic) is an option.
• Patients should be instructed to eat frequent small meals, avoid reclining for an hour after eating, elevate their head of bed (4-8 inches), and advance their diet slowly post-op.

Gastroesophageal Reflux Disease (GERD)

• GERD is a common disorder that involves backflow of gastric or duodenal contents into the esophagus, causing symptoms and/or mucosal damage.
• An incompetent lower esophageal sphincter, pyloric stenosis, hiatal hernia, or motility disorder can contribute to excessive reflux.
• GERD incidence increases with age, is associated with irritable bowel syndrome, obstructive airway disorders (asthma, COPD, cystic fibrosis), and risk factors such as tobacco use, coffee consumption, alcohol consumption, and gastric infection with Helicobacter pylori.
• Pyrosis and regurgitation are hallmark symptoms of GERD.
• Other symptoms include dyspepsia, dysphagia, hypersalivation, and esophagitis.
• Diagnosis is confirmed through pH monitoring, endoscopy, and barium swallow to evaluate for complications.
• Complications include dental erosion, ulcerations in the pharynx/esophagus, laryngeal damage, esophageal strictures, adenocarcinoma, and pulmonary complications.

Gastroesophageal Reflux Disease (GERD)

• Medical management includes medications and surgery.
• Patients should consume a low-fat diet, avoid caffeine, tobacco, beer, milk, peppermint/spearmint-containing foods, carbonated beverages, and abstain from eating or drinking 2 hours before bedtime.
• Elevate the head of bed at least 30 degrees, cease tobacco use, limit alcohol consumption, and maintain a healthy weight.

Gastritis

• Gastritis is a disruption of the mucosal barrier that protects the stomach tissue from digestive juices.
• Acute gastritis is characterized by rapid symptom onset, often caused by dietary indiscretion, and is typically self-limiting.
• Other causes of acute gastritis include medications, alcohol, bile reflux, radiation therapy, and ingestion of strong acids or alkalis.
• Chronic gastritis is characterized by prolonged inflammation, gastric tissue atrophy, benign or malignant ulcers, and is often linked to Helicobacter pylori infection.
• Other causes of chronic gastritis include autoimmune diseases, dietary factors, medications, alcohol, smoking, and chronic reflux of pancreatic secretions or bile.

Acute Gastritis

• Acute gastritis can be classified as erosive or nonerosive.
• Erosive gastritis can be caused by local irritants such as aspirin, NSAIDs, corticosteroids, alcohol, radiation, or severe cases caused by ingestion of strong acids or alkalis.
• Nonerosive gastritis can be caused by Helicobacter pylori (H. pylori) infection, leading to peptic ulcers.
• Stress-related gastritis occurs in situations like severe burns, infection, lack of perfusion, and surgery.
• Complications include perforation, scarring, pyloric stenosis, tissue atrophy, and hemorrhage.

Manifestations of Gastritis

• Acute gastritis symptoms include epigastric pain, dyspepsia, anorexia, hiccups, nausea, vomiting, and may lead to melena, hematemesis, or hematochezia in erosive gastritis.
• Chronic gastritis symptoms include fatigue, pyrosis, belching, a sour taste in the mouth, halitosis, early satiety, anorexia, nausea and vomiting, and pernicious anemia due to B12 malabsorption.
• Some cases of gastritis are asymptomatic.
• Mild epigastric discomfort with intolerance of spicy or fatty food, relieved by eating, may also be present.
• Definitive diagnosis requires endoscopy and histologic examination of biopsy specimens.

Medical Management of Gastritis

• Acute gastritis recovery typically occurs within 1-3 days.
• Patients should refrain from alcohol and food until symptoms subside.
• Supportive therapy includes IV fluids, nasogastric intubation, antacids, histamine-2 receptor antagonists, and proton pump inhibitors.
• Chronic gastritis management involves dietary modifications, promoting rest, stress reduction, avoiding alcohol and NSAIDs, and pharmacologic therapy.
• Treatment may necessitate NG tube placement, endoscopy, or surgery for perforation or hemorrhage.

Nursing Management of Gastritis

• A calm and reassuring approach should be used, explaining all procedures and treatments to reduce patient anxiety.
• Optimal nutrition is encouraged, with patients initially on a nil by mouth (NPO) diet for acute gastritis. Clear liquids and solid foods are introduced as prescribed. Monitor for symptoms and report any concerns.
• Caffeinated beverages, alcohol, and cigarette smoking should be discouraged. Referral for alcohol counseling and smoking cessation programs are also encouraged.
• Promote fluid balance by monitoring intake and output, watching for signs of dehydration, electrolyte imbalance, and hemorrhage.
• Implement measures to relieve pain by addressing dietary needs, promoting rest, administering medications as prescribed, and using relaxation techniques.
• Promote skin integrity by frequently assessing skin condition, ensuring adequate hydration, and providing proper hygiene care.
• Observe for and report signs of complications, including bleeding, perforation, and infection, to prevent further complications and enhance patient safety.

Test your knowledge on the digestive system, including digestion, absorption, and conditions such as perforation and hiatal hernia. This quiz covers various diagnostic methods and post-operative care. Perfect for students in health sciences or related fields.