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B260 Week 5
Transcript of B260 Week 5
The GI Track
Series of hollow mucous membrane lines muscular organs
Absorbs fluid and nutrients
Prepares food for absorption
Absorbs large volumes of fluids
Making fluid and electrolyte balance a KEY function
Mechanically and chemically breaks down food
food enters esophagus
passes through upper esophageal sphincter
sphincter prevents air from entering esophagus
prevents food from refluxing into throat
What happens during aspiration?
Produces and secretes hydrochloric acid, mucus, pepsin, and the intrinsic factor
Intrinsic factor: glycoprotien essential for the absorption of B12
processes chyme from stomach
absorbs carbs and protein
absorbs water, fats, some vitamins, iron, and bile salts
"lower GI track"
Healthy adults absorb more than a gallon of water and an ounce of salt every 4 hours
Factors influencing bowel elimination
Review box of types with therapies..
S/S include infrequent bowel movements (less than every 3 days), difficulty passing stool, excessive straining, hard feces.
What is the valsalva maneuver?
in what patient populations would this be a contraindication?
results from unrelieved constipation
collection of hardened feces wedged in the rectum that cannot be expelled.
If not resolved often results in an obstruction
When would you suspect impaction?
(what are the s/s of impaction?)
temporary or permanent?
an artificial opening in the abdominal wall: Stoma
Created in the ileum
bypasses the entire large intestine
Stools are frequent and liquid
ascending colon: frequent and liquid
more solid, formed stool
Care of Bowel Diversions
Why is skin care around stoma important?
First few weeks after surgery: low fiber diet, particularly with ileostomies
eat slowly, chew food completely, drink 10-12 glasses of water daily unless contraindicated
High fiber foods that may cause problems: stringy meat, mushrooms, popcorn, shrimp, crab
Foods that cause gas and odor:
A patient is admitted for a lower GI bleed. What color does the nurse expect the stool to be?
you are taking a health history of a patient newly admitted to rule out bowel obstruction. Which of the following is a priority question?
A. Describe your BM
B. How often do you have a BM
C. When was your last BM
D. Do you routinely use stool softeners?
you are caring for a 78 yo with diarrhea. of the following problems, which is the most important to consider?
C. Skin Breakdown
Promote complete emptying of feces from colon via large volume of solution/local irritation to stimulate peristalsis
Hypotonic. goes from bowel into interstitial spaces. DO NOT repeat tap water enema due to water toxicity or circulatory overload
Safest to use, exerts the same osmotic pressure as fluids in interstitial space surrounding bowel.
exerts osmotic pressure pulling fluids OUT of interstitial space. Colon fills with fluid. good for patients who cannot tolerate large amounts of fluid. BAD for dehydration and young infants!!
Castiel soap. use with caution in pregnant women and older adults, may cause electrolyte imbalance
lubricate the rectum and colon. feces absorb the oil and become softer/easier to pass.. retain for several hours if possible (wow).
May take 3 times to be "clear"
Caution against more than 3
depletes fluids and electrolytes
giving an enema sitting on toilet is not safe