Notes #1 Disturbances in Ingestion PDF

NCM 116 Care of The Clients with Acute and Chronic Problems in Nutrition, By: Lourdes Ivaliz C. Iledan, RN, Gastro-internal, MN Metabolism,  Course Outline I. NUTRITIONAL-METABOLIC PATTERNS/RESPONSES TO ALTERED NUTRITION P...

NCM 116 Care of The Clients with Acute and Chronic Problems in Nutrition, By: Lourdes Ivaliz C. Iledan, RN, Gastro-internal, MN Metabolism,  Course Outline I. NUTRITIONAL-METABOLIC PATTERNS/RESPONSES TO ALTERED NUTRITION PA RT 1. D I S T U R B A N C E S I N I N G E S T I O N A. G A S T R O E S O P H A G E A L R E F L U X D I S E A S E ( G E R D )  PATHOPHYSIOLOGY  ASSESSMENT FINDINGS (TO INCLUDE LABORATORY & DIAGNOSTIC EXAMINATIONS)  TREATMENTS  NURSING DIAGNOSIS B. H I ATA L H E R N I A  PATHOPHYSIOLOGY  ASSESSMENT FINDINGS (TO INCLUDE LABORATORY & DIAGNOSTIC EXAMINATIONS)  TREATMENTS  NURSING DIAGNOSIS C. A C H A L A S I A  PATHOPHYSIOLOGY  ASSESSMENT FINDINGS (TO INCLUDE LABORATORY & DIAGNOSTIC EXAMINATIONS) By: Lourdes Ivaliz C. Iledan, RN, MN  TREATMENTS  NURSING DIAGNOSIS INTRODUCTION OF THE NCM 116 GASTROINTESTINAL SYSTEM By: Lourdes Ivaliz C. Iledan, RN, What are the 6 main parts of the GI system? What are the accessory organs of the GI system? How does a GI system work? 6 MAIN PARTS OF THE GI SYSTEM : 1. Mouth 2. Esophagus 3. Stomach ALIMENTARY 4. Small Intestine CANAL 5. Large Intestine ( hollow tube lined 6. Rectum w/ mucous membrane ) ACCESSORY ORGANS : 1. Salivary glands 2. Liver 3. Pancreas 4. Gallbladder  2. 1. 3. 6. THE GI TRACT 4. FUNCTIONS: 7. 5. 1.Digest food 8. 10. 2.Absorb nutrients 9. 3.Propel the 11. contents through the lumen 4.Eliminate the What is the difference between Ingestion &  INGESTION DIGESTION Taking food through the Breaking up complex mouth into the body is molecules of food into called ingestion. simple and small molecules is called This is a physical digestion. process. It involves many chemical reactions. Enzymes are not Enzymes are required. required. Digestion takes 4-5 The process takes a few hours to complete.  PART 1. NCM 116 DISTURBANCES IN INGESTION By: Lourdes Ivaliz C. Iledan, RN, MN  A. GASTROESOPHAGEAL REFLUX DISEASE (GERD)  common disorder marked by backflow of gastric or duodenal contents into the esophagus that causes troublesome symptoms and/or mucosal injury to the esophagus.  P R E D I S P O S I N G FA C T O R S : P R E C I P I TAT I N G FA C T O R S : 1. Obesity 1. Smoking 2. Hiatal Hernia (bulging of the top 2. Eating large meals or eating late at night stomach up above the diaphragm) 3. Fatty or fried foods 3. Pregnancy 4. Alcohol, & Caffeinated drinks 4. H. Pylori infection 5. Medications that can cause GI upset such 5. Aged person as aspirin 6. COPD A. Impaired Lower Esophageal Sphincter (LES)–Low Pressures or Fr e q u e n t Tr a n s i e n t L E S R e l a x a t i o n B. Increase Abdominal Pressure  HYPERSECRETION OF ACID Impaired Peristalsis or Abnormal Saliva Production Decreased Acid Clearance Delayed Gastric Emptying or Duodenogastric Reflux Of Bile Salts & Pancreatic Enzymes  Hallmark Signs & Symptoms: 1. Epigastric burning, worse after eating 2. Heartburn 3. Burping (Eructation) or Flatulence 4. Sour taste in mouth, often worse in the morning 5. Nausea 6. Bloating 7. Cough due to reflux high in the esophagus 8. Sore throat 9. Hoarseness or change in voice  COMMON LABORATORY OR DIAGNOSTIC  Twenty-four-hour pH monitoring ph 50 y/o) 5. Smoking Size of the hiatus n o t fi x e d , n a r r o w s with increased intra-abdominal pressure Tear of Phreno-esophageal Ligament Hallmark S/Sx: SLIDING HERNIA 1. Heartburn Reduced LES Pressure 2. Dysphagia 3. Eructation Reduced Esophageal Acid 4. Chest Pain Clearance ROLLING HERNIA: 1. Chest pain Transient LES Relaxation 2. Shortness of breath after eating Episodes particularly at Night- 3. Feeling of fullness after eating time  COMMON LABORATORY OR DIAGNOSTIC  Twenty-four-hour pH monitoring ph