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Major Functions:
2. Ingestion of food
3. Digestion of food
4. Elimination of waste products
2 Main Groups:
7. Alimentary Canal
8. Accessory Organs
Organs of the Alimentary Canal
MOUTH
also known as ________
_______ protects its anterior opening
_______ protects its lateral walls
_______ forms its anterior roof
_______ forms its posterior roof
_______ fleshy fingerlike projection of the soft
palate
_____ occupies the floor of the mouth
_____ a pair of lymphatic tissue located at posterior
end of the oral cavity
_____ lubricates the food for easy swallowing
PHARYNX
allows the passage of food from the mouth to the
esophagus
ESOPHAGUS
Hollow, muscular tube that propels the food from
the pharynx down to the stomach
STOMACH
A dilated, saclike structure that lies on the left side
of the abdominal cavity nearly hidden by the liver
and diaphragm
Contains 2 important sphincters
The fundus is the expanded part of the stomach
lateral to the cardiac region
The body is the midportion and the funnel-shaped
pylorus is the terminal part of the stomach
It has 3 major function such as:
3. Stores food
4. Mixes food with gastric juices
5. Passes chyme
An average meal can remain in the stomach for 3
to 4 hours
An accordion-like folds in the stomach lining, allows
the stomach to expand when large amount of foods
and fluids are ingested
Chemical breakdown of protein begins in the stomach
SMALL INTESTINE
Considered as the body’s major digestive organ
Longest section of the GI tract and hangs in sausage
like coils in the abdominal cavity
SMALL INTESTINE
It has 3 sections:
2. Duodenum
3. Jejunum
4. Ileum
Nearly all food absorption occurs in the small
intestine
LARGE INTESTINE
LIVER
Heaviest organ in the body
Located in the right upper quadrant and almost
completely covers the stomach
Has 2 major lobes divided by the falciform ligament
The liver’s function includes
M-etabolism of Carbohydrates, Fats and
Proteins
C-onverts ammonia to urea for excretion
D-etoxify blood
O-synthesizing plasma proteins, nonessential
amino acids
acids, vitamin A and essential nutrients
such as iron, and vitamins D,K, and B12
S-ecretes bile. A greenish fluid that helps
digest fats and absorbs fatty acids,
cholesterol, and other lipids.
GALLBLADDER
Small, pear-shaped organ that lies halfway under the
right lobe of the liver
Its main function is to store bile from the liver until it
is emptied into the duodenum
PANCREAS
Soft, pink, triangular gland that extends across the
abdomen from the spleen to the duodenum
Produces enzymes that digest carbohydrates fats and
proteins (ALT)
BILE DUCTS
Provide the passageways for bile to travel from the
liver to the intestines
2 hepatic ducts drain the liver and 1 cystic duct drains
the gallbladder
METABOLISM
Serum bilurubin
Serum alkaline phosphatase N=2-5
bodansky unit
SGOT Serum Glutamic Oxalo Transaminase
or AST Aspartate Aminotransferase N= 7-
40 U
SGPT Serum Glatamic Pyruvic
Transaminase or ALT Alanine
Aminotransferase N= 10-40 U
Todetermine metabolic
function
Serum protein- albumin, globulin
Serum ammonia- N= 20-150 ug/
100ml
Serum amylase N= 4-25 u/ml
Prothrombin time N=11-16 secs
Barium swallow
- identifies structural abnormalities of the
esophagus, stomach, duodenum and
jejunum as well as swallowing
discoordination
Pre-test prep:
2. Low-residue diet several days before the
procedure
3. NPO for 8 to 12 hrs before the test
4. BaSO4 per orem is administered
5. X-rays are taken in standing and lying
positon
Post-test:
2. Laxative is administered
3. Increase fluid intake
4. Inform patient that the stool is white for 24-72
hours
5. Observe for Barium impaction: abdominal
distention and constipation
Barium Enema
Esophagogastroduodenoscopy (EGD)
- examination of the esophagus, stomach and
duodenum through an endoscope
- local spray anesthetic is given and anxiolytic agent to
provide sedation and relieve anxiety.
Post-test: Nurse monitors for any signs of
complication especially signs of perforation
- may not have food or fluids until the gag reflex
returns.
- Clear fluids are given first then progress to regular
foods according to the client tolerance.
Colonoscopy
Indications of NGT:
1. Gavage- to deliver nutrients; for feeding purposes
2. Lavage- to irrigate the stomach
3. Decompression- to remove stomach contents or air
Types of GI tube
Nursing Management:
Filter is used in the IV tubing to trap bacteria
Solution and administration equipment should
be changed every 24 hours
Dressing changes every 48-72 hrs with
antibiotic ointment to catheter insertion
Medication is never administered in a TPN line
Do not abruptly discontinue TPN
Observe for complications
Infection
Venous thrombosis
Hyperglycemia
Nursing Assessment
Anorexia, nausea or vomiting
Dysphagia
Dyspepsia (indigestion)
Pyrosis (heartburn)
Diarrhea or constipation
Regurgitation
Bleeding- hematemesis, melena,
hematochezia,
flatulence, aerophagia, borborygmus
Abdominal rigidity
Hiccup
Jaundice (obstructive)
Acholic stools
Common GI Diseases:
Appendicitis
Post AP
2. FOB for 6-8 hrs (spinal anesthesia)
3. Monitor for return of sensation on lower
extremities
4. NPO until peristalsis returns
5. Encourage ambulation
6. Proper positioning
7. Resume normal activities within 2 to 4 wks.
A. Peptic Ulcer Disease
- break in the continuity of gastric mucosa that
comes in contact with hydrochloric acid and pepsin
Predisposing Factors
- emotional stress, irregular meals excessive
smoking, drinking coffee or alcohol, drugs;
genetics
Incidence
- more in men with emotional stress; type O blood
Nursing Management
2. Rest
3. Bland diet- no caffeine, alcohol and spicy
foods
4. Stress nursing management
5. If with hemorrhage- gastric lavage
Gastric Ulcer Duodenal Ulcer
“Poor man’s ulcer” (50 “Executive ulcer” (25 to
y/o and above) 50 y/o)
Incidence: 20% - 80%
Location: Antrum - duodenal bulb
Pain: epigastric,30mins. - mid-epigastric, 3-4
a.c., not relieved by food
and antacids hrs p.c. 12mn-3am,
Weight: loss relieved by food
Hemmorhage: - weight gain
hematemesis - melena
Complication: - perforation
hemmorhage, CA
Medications:
Antacids-neutralizes hydrochloric acid and relieves pain;
give 1-2 hrs after meals.
Ex. Maalox, Kremil S, Amphogel, Milk of Magnesia
Anti- ulcer agent- protect ulcers from acid and pepsin.
Given 1 hr before meals (empty stomach)
H2 (histamine) receptor antagonists- inhibits gastric
secretions; given 1 hour a.c.
Ex. Cimetidine
Ranitidine
Famotidine
Anticholinergics- decreases motility and volume of gastric
secretions; give 30 min a.c.
Prostaglandin analogs – used to sustain the mucosal
layer especially those on long treatment with aspirin. Ex.
(Cytotec)
PPI- Proton Pump Inhibitor- supresses gastric acid by
blocking enzymes associated with the final step of acid
production. Given before meals. Ex.(Losec, Nexium)
Cytoprotective Drug- coats ulcer, taken on empty
stomach. Ex.(Carafate)
Helicobacter Pylori Drug- anti-microbials
Ex. (Amoxicillin, Flagyl)
Anticholinergics- reduce gastric motility and HCL
secretion
Ex. (AtSO4, Bentyl)
Surgery
Gastrectomy- removal of stomach- anastomosis
of esophagus and duodenum
Billroth I- gastroduodenostomy
Billroth II- gastrojejunostomy
Vagotomy- resection of vagus nerve to inhibit vagal
stimulation and decrease motility and gastric secretions
Pyloroplasty- enlargement of pyloric sphincter to permit
passage
Complication:
Dumping Syndrome
- rapid emptying of food
especially concentrated
carbohydrates in the duodenum;
food draws fluid from the blood
stream- hypovolemia
Signs and Symptoms Nursing Management:
faintness a. Small frequent meals
dizziness b. Chew food thoroughly
sweating c. Avoid high carbohydrate diet
nausea and d. Avoid liquid within meals
palpitations e. Lying down after meals-
flat for 5-30min p.c.
Chronic Inflammatory Bowel
Disorders
Crohn’s Disease Ulcerative Colitis
Early S/S
2. Weakness and fatigue
3. Anorexia
4. Tea-colored urine, clay-colored stool
5. Loss of axillary and pubic hair
6. Abdominal pain and shortness of breath
7. Skin itching
Late S/S
2. Nosebleeding, anemia
3. Spider angioma
4. Palmar erythema
5. Gynecomastia and testicular atrophy
6. Ascites and jaundice
Nursing Management:
2. Provide good nutrition. Vitamins and nutritional
supplements promote healing of liver cells
3. Monitor vital signs for alcohol withdrawal
4. Weight patient daily.
5. Monitor intake and output
6. Give small frequent feedings rather than 3 full
meals
7. Health teaching on abstinence from alcohol
7. Omission of all sedatives (detoxified by
liver)
8. Butter ball diet- foods rich in
carbohydrates are protein sparing
nutrients- they are used by the body for
energy in place of protein
9. Abdominal paracentesis
Complications:
Incidence: (5 F’s)
a. Female
b. Forty (age- 40 years and above)
c. Fair complexion
d. Fertile
e. Fat
Nursing Management:
Promote rest
Maintenance of food and fluid intake
Prevention of injury
Provide comfort