Digestive System Structure Abdominal Quadrants Abdominal Regions Mouth

Digestive System

Structure

Abdominal Quadrants

Abdominal Regions

Mouth • where the digestive process begins • consists of the tongue, salivary glands, teeth, and pharynx

Esophagus • A tube 10 to 12 inches long that carries food from the mouth to the stomach

Stomach • a hollow, muscular, J-shaped organ • holds food from 3 to 4 hours • has three parts: the fundus, body, and pylorus • produces gastric juices that help break down food

Intestines • the small intestine: where most of the food the body needs are absorbed into the bloodstream • the large intestine: where most water is absorbed, wastes are changed into solid form

Appendix • function is not known • attached to the cecum

Liver • The largest gland in the body • helps control the amount of protein and sugar in the body by changing and storing excess amounts

Gallbladder • a small hollow sac that is attached to the underside of the liver • it releases bile from the liver into the small intestine to help digest a fatty meal

Pancreas • located behind the stomach • aids in the digestion of food • produces insulin

Common Conditions of the Digestive System

Malignancies • very common • symptoms depend on location – indigestion – vomiting – constipation – obstruction – bloody stool

Ulcerations • a sore or tissue breakdown • common places: colon, stomach, duodenum

Hernias • the intestine pushes through a weakened area of the abdominal wall

Gallbladder Conditions • cholecystitis: inflammation of the gallbladder • cholelithiasis: formation of stones in the gallbladder

Common Problems Related to the Lower Bowel • diarrhea: multiple watery stools • constipation: when stool passes through the colon too slowly – most severe form: fecal impaction • bowel incontinence: involuntary passage of fecal material from the anus

Procedures Related to the Digestive System

Nasogastric Tube

NG Tube cont. • may be placed for stomach decompression (ex. – during CPR) • to give stomach rest • to relieve nausea

Normal CT of Abd

CT Scans • CTs may be done of abd/pelvis, with or without contrast (IV or PO) • used to diagnose abnormalities/conditions of digestive system

Esophagogastroduodenoscopy (EGD) • May be used to diagnose problems of the esophagus, stomach or duodenum • May be done in GI Lab at a Hospital as an outpatient

Nutrition • Food & fluids contain Nutrients-a substance the is taken in , digested, absorbed, and used by the body • Grouped into fats, proteins, carbohydrates, vitamins, minerals, and water (FPCVMW) • Which nutrients give the body fuel for energy? • FPC • Energy measured in calories • Food guide pyramid helps to guide healthy food choices-has 4 levels

Nutrients • Essential nutrients • Sometimes special diets come from many needed to manage different foods nutrition in patients • Refer to basic information sheet about nutrition

Fluid Balance • Water needed to live • Death can occur if there is too little or too much • Water is taken in through food and fluids • Water lost through elimination of urine and feces also through vomiting, perspiration and exhaling • To be healthy fluid balance is needed • Fluid taken in (intake) and lost (output) needs to be equal • Swelling (edema) occurs when more is taken in than put out • Dehydration occurs when more fluid is put out than taken in

Fluid Balance • Adults need to take in • Sometimes patients 1500 ml per day require special orders for fluids • For normal fluid balance • Fluids may need to be about 2000 -2500 ml is encouraged to increase needed per day intake • Normal person can take • Fluids may be restricted fluid orally to a certain amount per day

Enteral Nutrition-Tubes • Nutrition given by gavage (tube feeding) • Different types of tubes • Nasogastric (NG) inserted through the nose • Gastrostomy- inserted into the stomach through a surgically created opening • Jejunostomy – inserted in to small intestines through surgically created openint • Percutaneous endoscopic gastroostomy (PEG) Tubeinserted into the stomach with an endoscope and through a puncture wound made through the skin into the stomach

Enteral Nutrition-Formula • Formula ordered by • Feedings may be doctor continuous or scheduled at intervals • Most contain all of the nutrients • If they are continuous a pump is used to give the • Sometime may be made feeding by the dietary department • Scheduled feedings may be given with a syringe or tube feeding bag that allows feeding to drip

Enteral Feeding- Observations • Major risk is aspiration – • Nurse must regularly which is breathing in of make sure tube is in the fluid or an object into right place because the lungs tubes can move from coughing and sneezing • Aspiration cause or vomiting pneumonia and death • It is important to take measures to prevent aspiration

Tube Feeding-Preventing Aspiration • X-ray may be taken after tube is inserted to verify placement • Nurse may check tube placement by aspirating gastric secretions • Prevent regurgetation by positioning patient in semi-Fowler’s Position – ask nurse of check care plan to find our how long • If there is a delay in stomach emptying can regurgitate feeding • Avoid left side lying position • Less of a problem with J-Tube

Observations for Patients receiving Tube Feedings • Observe and report immediately to nurse: • Nausea, vomiting • Diarrhea • Discomfort during tube feeding • Enlarged or swollen stomach • Elevated temperature • Redness, swelling, drainage • odor or pain at the insertion site • Difficulty breathing • Elevated pulse rate • Coughiing • Complaints of bloating or flatulence

Intravenous Therapy • This is giving fluids by way of a needle or catheter that has been inserted into a patient’s vein usually by an RN • May be given in various settings such as hospital, outpatient, doctor’s office, home care setting, long-term care setting • Requires a doctor’s order • Given to replace fluids, replace vitamins and minerals lost from illness or injury • Blood and blood products are given through IV

Intravenous Therapy Sites • Peripheral Sites- away from the center of the body • Sites may be in the hand, wrist, and antecubital space ( bend of elbow) • If site is an IV catheter or needle facility may allow PCT to discontinue • PCT must know how and have been delegated this responsibility by the RN before attempting to D/C an IV. • Central Venous

TPN • Provides total parenteral nutrition (TPN) also called Hyperalimentation to patients. • May be given through aperipheral • TPN contains all of the essential nutrients needed to sustain life, Fat may be added in the form of lipids

Specimen Collection Principles • Adhere to medical asepsis principles • Follow Standard Precautions • Use a clean or sterile container for each specimen • Use the right container for the specimen Label the specimen correctly • Avoid touching the inside of the container and lid • Urine must be free of feces • No tissue in urine and stool specimen • Place specimen in plastic bag • Specimen should be taken to lab promptly