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GI Final & additional GI info Sorry for any misspelled words.

Mouth

Mastication: chewing
Saliva
Salivary glands produce about 1.5 liters of saliva daily
Salivary amylase (ptyalin) begins to break down starch (inactivated in the stomach)
Salivary lipase: begins fat digestion, but has minimal effect
Mucus to lubricate the food for easier swallowing
Lysozyme to kill bacteria

Tongue

Taste receptors: sweet, sour, salty, bitter, savory
Enzymes to help break down fatty acids

GI System

What breaks down food & prepares it for absorption
Non-absorbable substances pass through & are eliminated as solid waste

Solid Waste

Non-absorbable substances pass through & are eliminated as?

Liver, Gallbladder, Pancreas

What are other essential accessory components that aid the GI System in the break down of food & prepares it for absorption?

GI Tract

The primary function of the ________ is to
Metabolize toxic agents
Produce clotting factors
Provide nutrients needed for metabolism

Caries

Another term for Tooth Decay. Breakdown of tooth enamel, later invades dental pulp

Bacteria

Caries is caused by____________ which is nourished by foods particles left on teeth-faulty brushing/flossing-plaque on teeth & sugar in the mouth.

q6 month, twice a year

How often should adults have their teeth checked and cleaned?

Periodontal

What disease Affects bones & tissues around teeth?

Gingivitis

Inflammation of the gums

Pyorrhea alveolaris

Inflammation of gums & teeth (purulent discharge)

Systemic Infection

If Pyorrhea alveolaris is left untreated can cause

antibiotics & extraction

Treatment for pyorrhea alveolaris includes- surgical scraping & drainage, _________ & ___________

Stomatitis

inflammation of the oral mucosa; Caused by:
Primary: Virus & Fungi
Secondary: Irritants

Acute Herpes Simplex virus

small clear vesicles in single or multiple eruptions. Lasts 10-14 days. (viral stomatitis).

Candida albicans AKA Thrush

What fungi that causes a form of stomatitis is characterized by raised white patches & ulcers, can spread to other areas of GI tract, skin or resp. tract.
Tx Mycostatin swish & swallow

Irritants; Secondary

__________ aka toxic agents such as tobacco, alcohol, chemotherapy or radiation cause __________ lesions.

Mouth; anus

The GI Tract begins and ends where?

24-36 hours

How long does food take to move completely thru GI tract?

Tenesmus

Painful abdominal cramps or spasms

Dyspepsia & pyrosis

Heartburn aka indigestion

Micelle

Formed by bile salts , which are colloid (glue-like) particles, most often arranged in a parallel chain. Transport digested fats to the intestinal villi for absorption, then absorbed into lacteals->lymph.

anastomosis

The place where the two ends of the digestive system are joined together.

cachexia

General ill health & malnutrition

dumping syndrome

aka rapid gastric emptying is a condition where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested.

paralytic ileus

Intestinal paralysis

insufflation

Clients feel the air being instilled into the bowel.

mastication

chewing

steatorrhea

fatty stools that float

fistula

abnormal channeling between loops of bowel.

Currant Jelly Stools

Stools that contain primarily blood and mucus., movements of blood and mucus that contains no feces; common about 12 hours from the onset of intussisception

Anthelmintic

capable of expelling or destroying parasitic worms

chelating agent

a substance that forms complex ions with metal ions in solution

colic

acute abdominal pain (especially in infants)

invagination

the condition of being folded inward or sheathed

Kussmaul breathing

gasping, labored breathing, also called air hunger

kwashiorkor

a form of protein deficiency, most often seen in starving children, characterized by retarded growth and abdominal distention caused by liver enlargement

lactose

a sugar comprising one glucose molecule linked to a galactose molecule

marasmus

a condition caused by a diet low in calories AND protein. Children are usually thin, shriveled and tiny.

pruritus

severe itching

urticaria

hives; an eruption of wheals on the skin accompanied by itch

craniotabes

benign congenital thinness of the top back of the skull of a newborn.

pyloric stenosis

narrowing of the pyloric sphincter

dysphagia

difficulty in swallowing.

bolus

lump (of food)

Chyle

a milky fluid consisting of lymph and emulsified fats

emulsify

break fats into smaller droplets

peritoneal cavity

The space within the abdomen that contains the stomach, intestines, liver, gallbladder, pancreas, spleen, reproductive organs, and urinary bladder.

HCI

Hydrochloric acid; a digestive juices produced in the stomach; when protein content of the stomach rises, so does the HCI content; HCI helps buffer the PH of the stomach

H. pylori

Helicobacter Pylori:
a bacteria that may cause inflammation of the stomach lining and peptic ulcers in some people.

ileostomy

creation of a new opening through the abdominal wall into the ileum

colostomy

creation of an opening in the colon through the abdominal wall to create an abdominal anus allowing stool to bypass a diseased portion of the colon; performed to treat ulcerative colitis, cancer, or obstructions

Celiac Disease

Also know as gluten-sensitive enteropathy. A permanent intolerance to gluten, the protein component of wheat, barley, rye and oats.

coffee ground emesis

Coffee-ground emesis is vomiting of dark brown, granular material that resembles coffee grounds. It results from upper GI bleeding that has slowed or stopped.

Endoscopic Retrograde Cholangiopancreatography

ERCP is an ______ _______ __________ _________, direct visualization of the esophagus, stomach, duodenum, ducts of the pancreas & biliary tract structures.

Achalasia

A motility disorder of the lower portion of the esophagus in which food cannot pass into the stomach.

Hernia

An abnormal protrusion of intestine thru the muscle, can also develop around an incision or stoma.

Reducible Hernia

One that may be pushed back into the intestine by lying down & pressing on the abdomen.

diaphoresis

sigh/symptom that indicates shock; excessive perspiration, may result in wet clammy feeling when the skin is touched

Antacids

Used: Indigestion, reflux esophagitis & peptic ulcers & oth gastric irritants.
Ex: Aluminum Hydroxide (Amphojel); Magnesium, & Alum Hydro & magesium combo (Gelusil, Maalox, Mylanta)
Works by: Neutralize gastric acid, inhibit gastric acide secretions, provides mucosal protection.
Other Affects: can decrease absorp of other antacids, iron, quinolones, tetracycline and EC tabs.

Aluminum Hydroxide

Which antacids can cause constipation?

Magnesium Hydroxide

Which antacids can cause diarrhea?

Histamine2-Receptor Antagonists (H2 Blockers)

Used: Heartburn, prevent or treat active duodenal u. & gastric hypersecretion, prophylaxis for stress ulcers.
Ex: Cimetideine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), nizatidine (Axid)
Other affects: Allow 1hr betwn eating or doses of antacid & takiung H2 Blockers. dizziness, confusion,caution in elderly.

Proton Pump inhibitors (PPI)

Used: Esophagitis, GERD, gastric & duodenal ulcers, NSAID-related ulcers, & H.pylori
Ex: esomeprazole(Nexium), lansoprazole (Prevacid), omeprazole (prilosec), pantoprazole (Protonix), rabeprazole (Aciphex)
Other: take whole, may interfere with metabolism &/or absorp of oth drugs. read drug effects.

Cholinergic Blockers

Used: Adjunct therapy for peptic ulcer dis
Ex: glycopyrrolate (Robinul), mepenzolate bromide (Cantil), methscopolamine bromide (Pamine),propantheline (Pro-Banthine)
Other: Ck for GI Bleed, Abd pain, Avoid GI irritants

Miscellaneous Antiulceratives

Used: Short-term Tx & prevention of gastric, duodenal, & stress ulcers, used separately or in conjunction w/oth antacids/antiulceratives to destroy gastric acid by neutralizing all or part of the acid, absobing the acid, or making acid inactive.
Other: May decrease absorp of other drugs. M
Bismuth subsalicylate may darken tongue or stools. Sooths, topical protective coating on the stomach mucosa.

H. pylori Meds

Antibiotic therapy cobos of amoxicillin, clarithromycin (Biaxin), tetracycline, and/or metronidazole (Flagy) with H2 blocker

75%

H. pylori is found in about _____% of duodenal ulcers.Many do not develop an ulcer. Most of the remainder of ulcers are caused by NSAIDs.

GI Meds

Antidiarrheals, Antiemetics, Emetics, Laxatives & Cathartics, Stool Softeners, Antilipidemic.

Bulk Forming

GI Meds: methylcellulose (Ctrucel), polycarbophil (FiberCon), psyllium (Metamucil)

Lubricant

GI Meds: Mineral oil (Fleet Mineral Oil Enema)

Hyperosmotic

GI Meds: lactulose (Cephulac)

Saline Cathartic

GI Meds: magnesium sulfate, polyethylene glyco-electrolyte solution (Golytely)

Cathartic/Purgative

GI Meds: senna (Senokot), bisacodly (Dulcolax), sodium phosphate & sodium biphosphate (Fleet Phospho-Soda)

IBS

teaserod maleate (Zelnorm)

Surfak

Stool Softener

GERD Meds

Meds: H2Blockers, proton pump inhibitors (PPIs), GI stimulants, cholinergics, and antacids such as Mylanta, Rolaids, or Tums.

Prevacid (Lansoprazole) & Nexium (Esomeprazole)

Which GI Meds: Reduce the secretion of gastric acid by inhibition of the hydrogen-potassium adenosine triphosphate (ATPase) enzyme system of the gastric parietal cells.

Liqu 1-2 hrs, Solids 2-3 hrs (~1-4 or 5 hrs)

How long does food take to empty from the stomach?

3-6hrs

How longs foods takes to absorb in the small intestine
(Taken from the internet)

colo-rectal (colon cancer)

Risks for ___________Cancer are: Family Hx of _______, hx of polyps; precursors of ________cancer; Hx of IBD, & a diet high in fat & protein & low in fiber. pg 1365 RD

Hep A & E

What forms of Hepatitis are not chronic?

Hep B, C, D

What forms of Hepatitis have no cure (chronic)?

Interferon & Ribavirin

What is a Trmt for Chronic Hep B & Hep C?, an antiviral protein produced by cells that have been invaded by a virus

Hep C or HCV

Hep___? 6-7 wks Average, Range 2-26wks, s/s Clinical Janundice 30-40% (20-30% )Illness Chronic Hep 70%; Persistant Infection 85-100%; immunity/none; no protection, antibody, resp volentify. ______: Most contagious, Blood & Body Fluids, Mod. Contagious: Saliva, Semen, Vaginal; Mild Contagious: Sweat

Hep B or HBV

Hep _____: Vaccine 1mo-1mo-6mo, Booster, Easier to get
HBV & HCV: Most contagious, Blood & Body Fluids, Mod. Contagious: Saliva, Semen, Vaginal; Mild Contagious: Sweat
No immunization

Hep A or HAV

Hep___: Oral Fecal, Water, and Food:, Community Living; Vaccine for child only. Tx: Immunity Serrum Globilin for those Infected as Propylatic.

Hep D or HDV

Which hepatitis is a coinfection with HBV?

Hep E or HEV

Which hepatitis is rare in the USA?

Peritoneal cavity

Where are these organs located: stomach, intestines, liver, gallbladder, pancreas, spleen, reproductive organs, and urinary bladder.

Digestive

The ________System consist of the Mouth, Salivary glands (Parotid, Sublingual, Submandibular), Pharynx, Trachea, Esophagus, Stomach, Diaphragm, Liver, Gallbladder, Duodenum (of small intestine)Common bile duct, Spleen, Pancreas, Large intestine (transverse colon), Small intestine, Cecum Appendix, Sigmoid colon, Rectum, Anus

Accessory Organs

The, pancreas, gallbladder, liver, salivary gland are known as the ________organs

Pancreas

What organ Produces Glucogon & Insulin; Manufactures digestive Enzymes: amylase(starch/CHO & Trypsin(protein), peptase (fats/tricly); supplies Bicarb to neutralizee HCL/Chyme. pg 272 RD

Gallbaldder

What organ Stores & Releases Bile; small Intestine releases CCK, causes Gallbladder to contract (Peptids, amino), Salts to process fat, holds 2 oz of bile as.

Liver

What organ Largest Gland; Detoxifier; Bile-Emulsifies fats; stores glucose (as glycogen); Heparin-Anticoagulant; Plasma proteins Albumin-Provides osmotic pressure for blood pressure;Fibrinogen-Necessary for blood clotting;Prothrombin-Necessary for Blood Clotting;Globulins-Forms immunoglobulins(antibodies). filters blood;breaks down fat & protein;stores protein, fat, CHO & minerals, incl iron;Prepares waste (urea); absorbs bilirubin; Regulates amino acids Produces body heat; Detoxifies poisons; Forms vit A; stores vit A,D,E,K, & B complex Forms triglycerides & cholesterol. pg 272

Salivary Gland

Parotid, Sublingual, Submandibular are called the _______ Glands; the produce 1.5 liters of Saliva a day.

Liver Gland

What gland acts as the detoxifier; blood clotting Vit. K; Glucose Storage; Produces Bile (Fat Emulsifier); Synthesizes Amino, Protein, Vit. & Fats; Biliary Ducts aka Hepatic Ducts: Cystic Gall Duct, Hepatic Duct & Pancreatic Duct join in on common bile duct.

A, D, E, K

What are the fat soluble vitamins?

B, C

What are the water soluble vitamins?

Macronutrients

What type of nutrients are Carbohydrate, fat, & protein provide energy? page 301 RD

Micronutrients

What type of nutrients are Vit & minerals; regulate body processes?

Small Intestine

92-97% of nutrients absorb in the?

Large intestine

Water absorbs in?

Diarrhea

What is characterized by Loose freq Watery Stools,light in color, foul smelling. May contain mucus, pus, blood or fats. x?(high frequency)

Constipation

What is characterized by Hard, dry stool that is difficult to pass?

Obstipation

What is characterized by constipation that is now impacted?

4-6; bleeding.

After Liver Bx, LVN positions pt on their R side, applys pressure for _____ hrs, using sandbag or blanket to prevent _________.

Vital Signs

after Liver Bx, LVN takes _________ q 15mins for 1hr, q 30min for 4hrs; hourly for 8 hrs.

Shock

After Liver Bx, hemorrhage into abd from puncture site may occur; LVN watches for signs of _______

LVN

It is the responsibility of the _______ (medical staff) to Explain the procedure; assist client maintain proper position during procedure; wear gloves, stay w/client for support & encouragement.

Right

After Liver Bx, the Lvn positions pt on there _____side.

CCK; cholecystokinin

inhibits gastric glands, stimulates pancreas to release enzymes, stimulates GB to release bile

Gallbladder

What stores & releases bile?

Stomach

Mechnical & Chemical digestion occur in ?

Mouth

Starch digestion BEGINS in the ______ and CONTINUES in the stomach pg 273 RD

Duodenum

Fats are digested in the ________ small intesting using CCK.

Proteins

_______ is broken down by pepsin in the stomach and the, protein get further broken down into amino acid and absorbed in the Small Intestine

Villi

Fingerlike projections on the small intestine( capillary network) absorb 85% of nutrients to bloodstreem to cells, by hepatic portal.

Microvilli

microscopic folds of the cell membrane, covers each villi

Lacteals

What are the dead-end lymph capilllaries in each villi that absorb fat soluble nutrients ->lymph system -> thoracic?

parasympathetic nervous system

What system stimulates digestion & peristalsis (per Mrs. Dicson)

Hemorrhoids

Swollen (varicose veins of the anus or rectum) are called?

Cholecystogram

A diagnostic test that outlines the gallbladder & any existing gallstones?

Gastric Ulcer

s/s of _____ _____ are Vomiting blood or passing melena (ext hemorrhage. If bleeding massive, signs of shock-pallor, weak & rapid pulse, low blood pressure, faintness & collapse, coffee-ground emesis; if small & gradual, blood in stool. pg 1354 RD

white & chalky

After a barium enema, stools appear ______ & ______ pg 1338 RD

paracentesis

Medical term for abdominal tap?

Abdominal Tap

aka paracentesis, a procedure that may be necessary for diagnostic purposes or to relieve ascites, for diagnostic study, for culturing when bleeding or infection is suspected. Therapeutic abd tap if pt is distended w/ascetic fluid, help pt breath better. pg 1349 RD

Ultrasound; catheter

_____________may be used to guide the aspiration of fluid from the abd w/a large syringe & needle. A _________ may be inseerted into the abd cavity for cont. drainage. pg 1349 RD

ascites

What is fluid accumulation in the peritoneal cavity called?
pg 1349 RD

Hiatal hernia

What medical term is used to describe when a Part of the stomach protrudes through the diaphragm's esophageal hiatus (gap or cleft through which the esophagus passes). Weakening of the diaphragmatic muscles a gastroesophageal junction, trauma, or congenital. pg 1352

Appendicitis

What does rebound tenderness at the McBurney's point indicate? pg 1362 RD

Gastroenteritis

Medical Term for Stomach & intestinal inflammation-Overeating, ingesting irritating medications, poisonous food, abusing alcohol or microbial infection.

Ulcerative Colitis

Medical Term for Inflammation & ulceration of mucosa & submucosa (colon's lining), can span entire length of colon, freq begins in the rectum & distal colon. pg 1361 RD

gastroscopy

Examination of the upper GI tract with a gastro scope - Tabers p934)

Low-residue & increased

The diet recommendations for A pt w/ Ulcerative colitis or Crohn's disease is _______ & _________ protein diet, decreased lactose intake, vit supp, pg 1361 RD

Zenker's Diverticulum

herniation of the mucous membrane of the esophagus through a defect in the wall of the esophagus. The location is usually in the posterior hypopharyngeal wall. Small diverticuli are asymptomatic.

s/s of Zenker's Diverticulum

Large ones trap food and may cause esophageal obstruction, dysphagia, or the regurgitation of food. Treatment is surgical or endoscopic. also Bad breath.

Hirschsprung's disease

aka Congenital Aaganglionic Megacolon: Persistent constipation resulting from partial or complete intestinal obstruction of mechanical origin. Absence of parasympathetic ganglion cells within the muscular wall of the distal colon & rectum.

Gavage Feeding

Another name for enteral tube feeding, tube passed into the stomach through the nose or mouth. Infant/Older child. do not chk with inserting air(not reliable anymore) aspirate stomach content instead/ph acidic.

4-12 hr

pre-operative care for a young child, when NPO status would begin?

loses; dehydrated; projectile

A Baby suffering from pyloric stenosis is fussy, hungry, _____weight, becomes dehydrated; vomits milky substance, later______vomiting. Surgical correction necessary.

Pyloric Stenosis

Medical Term for Congenital anomaly. Increase in size of the musculature at the junction of the stomach & small intestine occurs, causing pyloric opening to constrict. Food can't pass thru.

Hepatitis

A person can develop ______ if they contract one of the viruses that can cause liver inflammation, or as a result of exposure to substances that can cause hepatitis - alcohol, fungal toxins and certain medicines.

Gastric Ulcers

What type of ulcer is caused by A break in the mucous barrier mechanisms that normally protect the stomach's lining. Risk Factors: Stress, Ethol, Smoking, Nonsteroidal anti-inflamm drugs, aspirin, inf. w/H.pylori,High-pigastrium pain 1-2 hrs after meals, eating may not relieve, weight loss.pg 1354 RD

Hydrochloric Acid (Free)

a digestive juice produced in the stomach; when protein content of the stomach rises, so does the HCI content; HCI helps buffer the PH of the stomach.

Dark Urine

A pt w/ hepatitis usually has what color urine? pg 1367 RD

Hernia

An abnormal protrusion of intestine thru the muscle, can also develop around an incision or stoma.

Reducible Hernia

What hernia is One that may be pushed back into the intestine by lying down & pressing on the abdomen?.

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