Transcript Nutrition Elimination: Digestive System

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
come from many
different foods
• Refer to basic
information sheet
about nutrition
• Sometimes special diets
needed to manage
nutrition in patients
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
1500 ml per day
• For normal fluid
balance about 20002500 ml is needed per
day
• Normal person can take
fluid orally
• Sometimes patients
require special orders
for fluids
• Fluids may need to be
encouraged to increase
intake
• Fluids may be restricted
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
• Sometime may be made
the 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
–which is breathing in
of fluid or an object into
the lungs
• Aspiration can cause
pneumonia and death
• It is important to take
measures to prevent
aspiration
• Nurse must regularly
make sure tube is in the
right place because
tubes can move from
coughing and sneezing
or vomiting
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