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60 Cards in this Set
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The digestive system, also known as the
Gastrointestinal System (GI) tract or the Alimentary System |
Is responsible for breaking down complex food into simple nutrients the body can absorb and convert into energy
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This process is known as digestion
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Mouth/ Esophagus
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Digestion begins in the mouth
The food is then swallowed as a small ball or bolus and transported down the esophagus |
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Esophagus
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A hollow, muscular tube 10 inches long.
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Peristalsis
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Coordinated rhythmic contractions of the muscles, pushes the bolus through the esophagus
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Stomach
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Aides in mechanical and chemical breakdown of the food
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Chyme
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The stomach mixes the partially digested food and digested enzymes into a semiliquid mass
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Pancreas
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Is a fish-shaped glandular organ 6-8 inches long
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The pancreas has both endocrine and exocrine functions
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The endocrine functions, which include the production of glucagon and insulin to regulate the blood sugar level, are presented in the endocrine system
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The pancreas produces three main groups of enzymes in pancreatic juice for its exocrine function
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Amylase: converts carbohydrates into glucose
Lipase: aids in fat digestion Protease: breaks down protein |
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Liver
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The liver is the largest glandular organ of the body
Located in the upper right quadrant of the abdomen It is one of the most vascular organs, filtering 1,500 ml of blood per minute |
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Some of the many functions of the liver
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*Produces and secrete bile, which emulsifies fat
*Convert glucose into glycogen for storage ( glycogenesis) *Convert glycogen to glucose when blood sugar level drops ( glycogenolysis) * Metabolize hormones * Breakdown nitrogenous wastes to urea * Incorporate amino acids into proteins * Filters blood and destroy bacteria * Produce prothrombin and fibrinogen, which are necessary for a blood clotting * Manufacture cholesterol * Produces heparin * store vitamin B 12 and fat-soluble vitamins A, D, E, and K * Detoxify poisonous substances |
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Gallbladder
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The gallbladder stores and concentrates the bile until it's needed in the small intestine
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The aging GI tract
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• loss of elasticity and slowed motility of the GI tract, accompanied by lack of exercise, make the elderly prone to constipation
• As the intestinal wall weakens, diverticuli, or scars on the intestinal wall, can develop • Decreased liver mass and blood flow alter the pharmacokinetics of various drugs |
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Changes in the Digestive System with aging
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* Decrease in peristalsis
Food moves more slowly through digestive system. Bowel movements are more infrequent. Increase in constipation. Feeling full and bloated and may eat less Increase fiber and fluid intake. Encourage smaller frequent meals. Offer fiber supplements |
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Oral changes
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Dentures are common.
Chewing is more difficult Eating and drinking time may be prolonged. Number of taste buds decreases Make sure dentures fit Cut food into small bites Teach that softer foods maybe better tolerated Some clients may start using more salt and seasonings to compensate for less flavor Monitor salt usage |
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Decrease in enzyme secretion
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Food is harder to digest
Increase in indigestion Intolerance to some food and seasonings Encourage water between meals Avoid foods that are not tolerated while ensuring adequate nutrient intake |
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Decrease in saliva
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Food is more difficult to chew
Swallowing becomes difficult Encourage fluid intake with meals Have clients chew food well and do two swallows with each bite of food Have clients sit up to eat |
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Stomatitis
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Painful condition characterized by inflammation
Ulceration of mouth Cause: By infections, damage to the mucous membranes by irritants, or chemotherapy Signs/ Symptoms Ulcerations & inflammation in the mouth Dx Culture maybe done to determine whether an infection process is present Treatment/ management Topical anesthetics such as xylocaine maybe use analgesic maybe ordered Diet Bland soft foods Liquids are tolerated As heal, diet advance |
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Nursing assessments
Nursing intervention |
Monitor intake calories
Fluid for adequacy Encourage client to eat soft , bland foods and liquids Assess for mouth discomfort Information ulceration Provide frequent oral care Meds |
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Esophageal Varices
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• Enlarged, tortuous ( twisted) veins
• Treatment: Sclerotherapy, ligation, balloon tamponade, and shunt placement • No non-steroidal anti-inflammatory drugs ( NSAIDs) aspirin, or anticoagulants Dx: Occult blood ( assess) Hematemesis Review H&H evaluate anemia and liver profile Patients teachings: Client should remain on bed rest if varices are bleeding or have recently bled If no bleeding is present Patient maybe ambulatory But avoid strenuous activity |
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Adhesion
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Internal scar tissue from previous surgeries or disease processes
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Appendicitis
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Inflammation of the vermiform appendix
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Ascites
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Abnormal accumulation of fluid in the peritoneal cavity
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Calculi
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Concentration of mineral salts
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Cholecystitis
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Is an inflammation of the gallbladder one>90% of the cases, gallstones are present
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Cholelithiasis
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Is the presence of gallstones or calculi
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Cirrhosis
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Chronic degenerative changes in the liver cells and thickening of surrounding tissue
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Colostomy
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Opening created anywhere along the large intestine
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Constipation
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Condition characterized by hard, infrequent stools that are difficult or painful to pass
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Diverticua
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Sac-like protrusion of the intestinal wall that results when the mucosa herniates through the bowel wall
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Diverticulitis
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Inflammation of one or more diverticula
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Diverticulosis
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Condition in which multiple diverticula are present in the colon
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Effluent
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Liquid output from an ileostomy
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Gastric Ulcer
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Erosion in the stomach
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Gastritis
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Inflammation of the stomach mucosa
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Glycogenesis
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Conversion of glucose into glycogen
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Glycogenolysis
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Conversion of glycogen into glucose
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Hematemesis
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Vomiting of blood
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Hemorrhoid
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Swollen vascular tissue in the rectal area
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Hepatitis
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Chronic or acute inflammation of the liver
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Ileostomy
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Opening created in the small intestine at the ileum
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Intussusception
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Telescoping of one part of the intestine into another
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Jaundice
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Yellow discoloration of the skin, sclera, mucous membranes, and body fluids that occurs when the liver is unable to fully remove bilirubin from the blood
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Ligation
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Application of a band or tie around a structure
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Melena
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Stool containing partially broken down blood usually black, sticky, and tar-like
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Occult blood test ( guaiac)
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Test for microscopic blood done on stool
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Pancreatitis
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Acute or chronic inflammation of the pancreas
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Peptic Ulcer
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Erosion formed in the esophagus, stomach, or duodenum resulting from acid/ pepsin imbalance
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Peristalsis
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Rhythmic, coordinated, serial contraction of the smooth muscles of the gastrointestinal tract
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Peritonitis
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Inflammation of the peritoneum, the membranous covering of the abdomen
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Polyp
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Abnormal growth of tissue
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Postprandial
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After mealtime:
A postprandial rise in the blood glucose level is one that occurs after eating |
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Steatorrhea
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Fatty stool
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Stoma
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Surgical opening between a cavity and the surface of the body
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Stomatitis
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Inflammation of the oral mucosa
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Volvulus
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Twisting of the bowel on itself
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Gastroesophageal Reflux Disease ( GERD)
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Is when gastric secretions flow upward into the esophagus, damaging the tissues
Cause: Inability of the lower esophageal sphincter to fully close Signs/ symptoms Dysphasia, esophagitis, epigastric, pain, heart burn , flatulence, melena, and bleeding Dx: Is made by symptoms, a 24 hour pH monitoring, and an esophageal motility test. An endoscopy determines the extent of esophagitis and rules out a malignancy Treatment: Generally treated with diet and medication. Clients are encouraged to lose weight if over weight A fundoplication is done to alleviate symptoms Antacids, H2 receptor antagonists, proton pump inhibitors, cytoprotective agents, and gastrointestinal motility agents Diet: Low fat , high-protein Avoid: caffeine, milk products, alcohol, peppermint, licorice, and spicy foods Elevate head of the bed 2-4 inches on blocks Avoid wearing constrictive clothing Observe for melena and signs of discomfort or pain |
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Laboratory tests
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Bilirubin: 0.1-1
Album: 3.5-5 Total protein: 6.4-8-3 Alkaline phosphate: 30-120/40-128 Aspartate aminotransferase (AST/SGOT) 5-40 Alanine aminotransferase ( ALT/SGPT) 8-20 Cholesterol:less than 200 Triglycerides: less than 150 Amylase 40-140/50-100 |
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Gastritis
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Cause:
Irritating substance such as medications, smoke, food allergens, or toxic chemicals, Signs/symptoms Upper abdominal discomfort or pain, nausea, vomiting, dyspepsia, diarrhea, bloating, burping Dx: Based on history and signs and symptoms An GUI or EGD is done to help diagnosis the condition If H pylori is suspected, a biopsy is obtained during an EGD and culture is preformed Treatment: Antacids and histamine (H2) receptor antagonists ( H2blockers) Proton pump inhibitor ( omeprazole / Prilosec) Prostaglandins is used Diet: Any foods that aggravate symptoms are eliminated Also foods that increase acid secretions such as milk, coffee, tea, cola, chocolate should be consumed in small amounts or eliminated if possible |
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Appendicitis
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If ruptures fecal content spills into the abdominal cavity causing peritonitis which maybe fatal
A barium enema or ultrasound is ordered to confirm inflammation in the appendiceal area show a WBC >10,000/mm and neutrophils >75% elevated temperature indicates infection rebound tenderness in rt. lower quadrant of the abdomen Surgical: Appendectomy Diet NPO and NG tube until bowel sounds return |
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