Assisting in Gastroenterology Chapter 32 1 LEARNING OBJECTIVES
Assisting in Gastroenterology Chapter 32 1
LEARNING OBJECTIVES LESSON 32. 1: ASSISTING IN GASTROENTEROLOGY 1. Define, spell, and pronounce the terms listed in the vocabulary. 2. Describe the primary functions of the GI system. 3. Identify the anatomic structures that make up the GI system and describe the physiology of each. 4. Differentiate among the abdominal quadrants and regions. 5. Summarize the typical symptoms and characteristics of GI complaints and perform telephone screening for patients with GI complaints. 2
LEARNING OBJECTIVES LESSON 32. 1: ASSISTING IN GASTROENTEROLOGY (CONT. ) 6. Distinguish among cancers of the GI tract. 7. List common esophageal and gastric disorders; also, describe the signs and symptoms, diagnostic tests, and treatments of each. 8. List intestinal disorders; also, describe the signs and symptoms, diagnostic tests, and treatments of each. 9. Do the following related to diseases of the liver and gallbladder: • Classify disorders of the liver and gallbladder, and list the signs and symptoms, diagnostic tests, and treatments for each. • Describe the similarities and differences among the various forms of infectious viral hepatitis. 3
Learning Objectives Lesson 32. 1: Assisting in Gastroenterology (Cont. ) 10. Summarize the medical assistant’s role in the GI examination. 11. Do the following when it comes to assisting with gastroenterology diagnostic procedures: • Explain the common diagnostic procedures for the GI system. • Demonstrate the procedure for assisting with an endoscopic colon examination. • Perform the procedural steps for assisting with the collection of a fecal specimen. 4
Learning Objectives Lesson 32. 1: Assisting in Gastroenterology (Cont. ) 12. Describe the medical assistant’s role in the proctologic examination. 13. Describe patient education, in addition to legal and ethical issues, related to assisting in gastroenterology. 5
ANATOMY AND PHYSIOLOGY GI tract sections Upper digestive system Lower digestive system Functions Digestion Absorption Elimination Salivary amylase mixes with food (creates a bolus) 6
ANATOMY AND PHYSIOLOGY (CONT. ) From Van. Meter KC, Hubert RJ: Gould’s pathophysiology for the health professions, ed 5, Philadelphia, 2015, Saunders. 7
DISEASES OF THE GASTROINTESTINAL SYSTEM Most common problems seen in medical offices Most are managed by the primary care physician 8
CHARACTERISTICS OF THE GI SYSTEM Peritoneum Membrane that lines abdominal wall and covers abdominal cavity organs Mesentery Attaches the jejunum and ileum to the posterior abdominal wall Omentum Hangs from stomach like an apron, covering anterior transverse colon and small intestine 9
ABDOMINAL QUADRANTS AND REGIONS 10
COMMON GASTROINTESTINAL COMPLAINTS Nausea Vomiting Diarrhea Constipation Abdominal pain 11
CANCERS OF THE GASTROINTESTINAL TRACT Any organ can develop cancer Features of malignant tumors Ability to invade surrounding tissues Metastasize through blood or lymph systems Increased risk from carcinogen exposure 12
DISORDERS OF THE ESOPHAGUS AND STOMACH Hiatal hernia Abdominal protrusion of part of an organ/tissue Gastroesophageal reflux disease (GERD) Gastroesophageal sphincter allows acid to leak back to the esophagus Gastric and duodenal ulcers Breakdown of mucosal membrane Pyloric stenosis Narrowing and hardening of the pyloric sphincter at distal end of stomach 13
HIATAL HERNIA AND PEPTIC ULCER From Frazier MS: Essentials of human diseases and conditions, ed 4, Philadelphia, 2009, Saunders. 14
DIAGNOSIS 15
TREATMENT OF GI DISORDERS 16
INTESTINAL DISORDERS Food-borne illness Irritable bowel syndrome Acute appendicitis Crohn’s disease 17
INTESTINAL DISORDERS (CONT. ) Ulcerative colitis Celiac disease Diverticular disease Hernias of the abdomen Hemorrhoids 18
ULCERATIVE COLITIS AND HERNIATED INGUINAL CANAL From Hagen-Ansert SL: Textbook of diagnostic sonography, ed 7, St Louis, 2012, Mosby. 19
DISEASES OF THE LIVER AND GALLBLADDER Cirrhosis Asymptomatic in early stages Hepatitis Viral hepatitis Cholelithiasis (gallstones) 20
DISEASES OF THE LIVER AND GALLBLADDER (CONT. ) 21
HEPATITIS Caused by localized infection, systemic infection, chemical exposure, or complication of drug metabolism Viral hepatitis (A, B, C, D, E, and G) causes sudden hepatocyte inflammation Transmitted through different means Can cause lifelong liver damage and increased risk of liver cancer Medical workers should be vaccinated First line of defense: Frequent hand sanitization and gloves 22
CHARACTERISTICS OF THE VIRAL HEPATITIDES 23
GROUPS AT RISK FOR HEPATITIS 24
CHOLELITHIASIS (GALLSTONES) Signs and symptoms Most asymptomatic Pain occurs when stones obstruct cystic or common bile ducts Nausea and vomiting may occur Diagnosis and treatment Based on symptoms; blood tests may be done; abdominal sonogram CT scan and magnetic resonance cholangiography may be ordered Surgical removal of gallbladder 25
GALLSTONES (CONT. ) 26
THE MEDICAL ASSISTANT’S ROLE IN THE GI EXAMINATION Assisting with the examination Carefully question the patient for a precise description of problem Liaison between the patient and physician Abdominal pain is often referred pain from another region Adjust drape to expose area that the physician is examining 27
DIAGNOSTIC PROCEDURES Barium swallow Upper gastrointestinal (UGI) and small bowel series; aircontrast UGI Barium enema; air-contrast barium enema (ACBE) Cholescintigraphy (HIDA scan) 28
DIAGNOSTIC PROCEDURES (CONT. ) Ultrasonography Sigmoidoscopy Colonoscopy Endoscopy 29
COLON FIBERSCOPES Monahan FD et al: Phipps’ medical-surgical nursing: health and illness perspectives , ed 8, Philadelphia, 2007, Saunders. 30
OCCULT BLOOD SCREENING Fecal examination is one means of evaluating patients with GI bleeding, obstruction, parasites, dysentery, colitis, or increased fat excretion Blood is not found in the stool of healthy individuals 31
PROCTOLOGIC EXAMINATION Diagnose disorders of colon, rectum, and anus Anal area examined with proctoscope Rectum and sigmoid colon examined with sigmoidoscope Remaining colon examined with colonoscope 32
CLOSING COMMENTS Patient education Listen to patient concerns and record them in the chart Report to the physician or note in the medical record Legal and ethical issues Responsibility is to assist the physician and act as the patient’s advocate All information exchanged between the patient and physician is private 33
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