GI Tract Anatomy and Function

• Assist. Prof. Dr. Funda KARAMAN is the lecturer.
• Ability to perform nursing practices regarding upper and lower digestive systems.
• Apply nursing interventions for diagnosis and treatment of digestive system.
• Topics include the digestive system, upper digestive system, and lower digestive system.

GI Tract Anatomy

• Dimensions: Approximately 30 feet (9 meters) from mouth to anus.
• Composition: Includes the mouth, esophagus, stomach, small intestine, large intestine, rectum, and anus.
• Liver, pancreas, and the gallbladder serve as associated organs via secretions.

Function of GI Tract

• Each part of the digestive system performs different activities.
• Ingestion and propulsion of food occurs in the mouth, pharynx, and esophagus.
• Digestion and absorption take place in the mouth, stomach, and small intestine.
• Elimination occurs in the large intestine.
• Various secretions play a role in digestion.

Factors Affecting GI Tract

• Includes stress and anxiety.
• Such factors include diet, alcohol, caffeine, cigarette smoking, fatigue, and diseases.
• Emotional and physical factors influence anorexia, epigastric and abdominal pain, diarrhea, and constipation.

Digestive System Organization

• Gastrointestinal (GI) tract forms a tube within a tube providing a direct path between organs.
• The GI tract consists of the mouth, pharynx, esophagus, stomach, small intestine, large intestine, and rectum.

Mouth

• Teeth initiate mechanical breakdown of food into smaller pieces.
• The tongue mixes food with saliva, amylase helps breaks down starch.
• The epiglottis closes over the trachea to prevent food from entering the trachea which is located in the pharynx.

Pharynx and Esophagus

• The pharynx is a common point for food and air transit.
• Esophagus: A 25 cm long tube canal for food transport from the pharynx to the stomach.
• The esophagus produces mucus from digestive secretions.
• Specialized sphincters prevent air passage at the upper end and prevent stomach contents from passing into the esophagus.

Peristaltic Motion

• Chewing in the mouth initiates peristalsis in the pharynx.
• Peristaltic movement pushes food to the esophagus and then to the stomach.
• The peristaltic wave spreads throughout the entire digestive tract.

Stomach

• It is J-shaped with approximately 1 liter of capacity
• Serves a temporary storage unit for nutrients.
• Nutrients are mixed with secretions and muscle movements.
• Digestion and absorption take place as they move toward the small intestine.
• Acid in the stomach kills bacteria.
• Major parts include, the cardia, fundus, body, antrum, and pylorus..

Small Intestine

• Duodenum, jejunum, and ileum are the main part of the small intestine.
• Ileocecal valve between the large and small intestines.

Small Intestine Functions

• Completes digestion, where carbohydrates and fats are broken down.
• Dimensions: Approximately 6-6.5 meters, extending from the pylorus to the ileocecal valve.
• Parts include the duodenum, jejunum, and ileum.

Large Intestine

• Has a length of 1.5 meters.
• Main functions include absorption of water and electrolytes.
• Forms and eliminates reservoir for feces.
• Made of the cecum and appendix, the colon (ascending colon on the right side, transverse, descending colon on the left side, sigmoid), the rectum, and anus.

Defecation

• A reflex action involving voluntary and involuntary control.

Assistant Organs

• Assistant organs include the liver, gall bladder, and pancreas with specialized ducts.
• A critical role in facilitating digestion

Liver

• Impacts digestion by producing bile.
• Bile facilitates fat digestion.
• Liver filters out toxins and waste, including drugs, alcohol, and poisons.

Gall Bladder

• Stores bile from the liver and releases it into the small intestine.
• Fatty diets increase the risk of gallstones.

Pancreas

• Produces digestive enzymes to digest fats, carbohydrates, and proteins.
• Regulates blood sugar by producing insulin.

GIS Diagnosis Methods

• Includes blood tests, urine, and gait analysis.
• It includes direct abdomen graph, ultrasonography, tomography, and endoscopic examinations.

Nutrition

• Problems occur in all age groups, cultures, and socioeconomic classes worldwide.
• Caregivers educate and resource people.

Nutrition & Diet Factors

• Include attitudes, cultural and religious preferences, economic factors, state of health, and psychological issues

Malnutrition

• an insufficient intake of one or more nutrients to meet the body's metabolic needs.

Obesity-Overweight

• Obesity: Individual weighs 20% or more over their ideal body weight.
• Overweight: Individuals with 10% more than average.

Causes of Excessive Weight

• includes little movement, malnutrition, and psychological problems.
• includes eating too much, metabolic disorders, and genetic factors.

Anorexia Nervosa

• Psychosocial illness: The individual starves, hates food, and experiences extreme weakness.
• Distorted self body image.
• Anorexia Nervosa, a fear of gaining weight.
• Refusal to eat

Anorexia

• It is a long-standing behavior with familial tendencies.
• Common use of laxatives and enemas.

Bulimia

• Characterized by consuming copious amounts of food at a high rate, followed by immediately induced vomiting.

Bulimia Consequences

• Vomiting leads to several conditions & electrolytic disturbances
• Esophageal lesions, tooth decay, endocrine disorders, and metabolic changes.
• Treatment: Includes nutrition, education, and psychological treatment

Nutrition Education Aims

• Development of adequate and balanced eating habits.
• Wrong practices avoided and adverse effects of food on health.
• Efficient and economic food resources.

Nutrition Support Methods

• Oral Routes
• Tubes: Nasogastric, Gastrostomy, Jejunostomy routes
• Parenteral Route: Total Parenteral Nutrition (TPN)

Oral Route Diets

• Fluid diet
• Soft diet (mash)
• Normal diet

Special Diets

• Treat diseases such as salt-free or low-salt for HT and diabetic diseases.
• Includes soft diet for special examinations or operation preparations
• The development and maintenance of health with a low-calorie diet in fat individuals.

Stomach Intubation

• Needed if a patient cant eat or swallow.
• Accomplished by inserting a nasogastric tube is inserted.
• Process: Know as nasogastric (NG) intubation.

Gastric Analysis

• Helps diagnose GIS.

Gastric Analysis Steps

• Examination of stomach contents
• Removing stomach contents through catheter placed in the empty stomach

Gavage

• Method supplies nutritional substance through a small, flexible tube directly to the stomach.

Lavage

• Gastric lavage, also known as stomach pumping or gastric irrigation, cleans out stomach contents.
• It is indicated when toxicity and overdose drug occur
• When the stomach bleeds
• When taking poison or foreign matter: the substance must be treated 4 hours after first being ingested

Decompression

• A procedure removes stomach contents to alleviate gastrointestinal system pressure.
• Relieves gastrointestinal system pressure.
• Alleviates distension accumulated in the gastrointestinal system.

GI Intubation Indications

• Indications are to decompress the stomach
• Used to removes gas and fluid, lavage to the stomach
• Removes ingested toxins, and diagnose disorders of GI motility and other disorders.
• Used to administer medications and feedings for treating an obstruction.
• Compresses a bleeding site.
• Aspirates gastric contents for analysis.

Nasogastric Tube Equipment

• Non-sterile equipment: 14 or 16 Fr NG tube, Ppe
• Pen to mark tube if needed
• Non-sterile gloves ,0.9% NaCl solution, tongue blade, flashlight, emesis basin, stethoscope
• Non-sterile: Disposable gloves, kidney bathtub
• Hypoallergenic tape
• 50 ml. pine end injector, a glass of water and pipette, treatment cloth, cottonwood, paper towel

Nasogastric Tube Procedure

• Explain the procedure to the client and placing seating in high follow position.
• Determine NG tube length to be inserted from tip of client's nose to earlobe.
• Measure distance from nose tip to the earlobe and to the xiphoid process

Application for Tube Insertion.

• Wash Hands & Put on clean gloves.
• Instruct to keep his head upright , gently insert catheter after wetting it to 20 cm with 0.9% NaCl solution.
• Direct the catheter to the nostril to the back of the throat then instruct patient’s to bent his head towards chest pass pharyx

Tube Insertion Tips

• Don't use liquid Vaseline and glycerine
• Tell the patient to mouth breathe.
• To facilitate swallowing, advance catheter each time the client swallows.
• If resistance is met stop advancement and retreat by tube is met or client starts to cough, choke or become cyanotic; stop advancing the tube and pull back.
• Swallowing provides epiglottis closure in the trachea.

NG Position

• Indicates entry of the catheter contents into syringe can used to confirm the position.

Testing Tube Placement

• Inject contents into syringe and give the catheter.

Aspiration Issues

• Advance the tube further if necessary
• Suspected PH intestinal placement between 4-6 then attempt the aspiration, ask the patient to lay to their left side after10 mins to do the same.

Aspiration Confirmation

• Auscultate by placing stethoscope over the patient’s epigastric as air enters with syringe then listen

Tube Secure after Place

• Always fix nose if catheter placement the catheter when is fixed

Gavage Applications

• Employed in semi-conscious or unconscious patients.
• Used for paralyzed patients and in those with mouth, facial injuries or surgery.
• Deployed in patients who cannot perform chewing or swallowing and on premature babies who do not have sucking and swallowing reflexes.
• In patients with Anorexia neuroses

Gavage

• Can be done using Gastricstomy or Jejunostomy
• Food is put inside with small portion

Food Storage

• Must be stored with temperature under 6hrs

Delivery Equipment

• Done with Injectors: Gavage food & with 2-50ml portion
• Used in continuous intervals & not to give large portions

Procedure & Aspiration Test

• The patient can be side on with 30 degrees & check with aspriration

Inject the Rest Amount

• The injector is kept kept in a 40 cm
• Food inside the injector can be kept for hours till injection.

Close the Catheter

• Keep it close up until food has been given & tube has been wash
• Prevent to give to much fluid

Nutritional pump

• Is what allows food being directly given hours upon hours

Complications

• Food need to make sure is can be digested by the patient
• Observe how fast or slow need to be given for the food.
• You must evaluate fluid loss

Test Glucose Urine Level Before Hand

• By checking Glucose levels it will help the process better way to make sure glucose level is balance

How Will You Help With Those

• Pay attention for patient intake and outtake

Give Medication The Best Way?

• By crushing those 5-10ml

A Gastosmy Is Done With?

• With stomach placement & giving Nutrition to provide food or ally

What Needs?

• Doctor is need & make procedure correctly

Gastosmy Tube

• Done through nutrition for 3 to 4 weeks, by placing a comatose state

Feeding Process Gastosmy

• Make sure to inject with wash fluid

Jejunosmy

• With people cant check & Dirahea can come

Jejunostmy Nutritional

• Those that ate in continues times with out stop

What Help

• Need water for tubes

TP Applications

• Severe diarrhea
• Pts at higher level of malnutrition

Complications

• Infections
• Metabolic complications

Nursing Care

• Vitals

Drug Distribution

• No distribution with another component

Lower Instestine Application

• Checking to do the proper bowel movement that is need to the patient.

Instestine

• Checking the the sound for it to be 15 secs from the proper

What Happen If Sound

• If sound is lower or higher number.

Bowel Moments

• Process which waste is removed from the bowel

Positive Factors

• Good bowel moment

Bad Inbowel

• Stress or anxiety

In Those

• Is more pressure or having to do hard bowel moments

What Can It Leads To

• Harding of tool

With Those Issues What Happen

• Gas & abdomen

With Inbalence What Do

Give regular bowel training.