Nursing Assessment and Management of Nutritional Problems
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The Intestinal Lumen, or Inner Wall has 4 layers:
- The mucosa, the innermost layer, includes a thin layer of smooth muscle and specialized exocrine gland cells.
- It is surrounded by the submucosa, which is made up of connective tissue.
- The submucosa layer is surrounded by the muscularis. The muscularis is composed of both circular and longitudinal smooth muscles, which work to keep contents moving through the tract.
- The outermost layer, the serosa, is composed of connective tissue.
Saliva contains mucin and an enzyme called
salivary amylase (also known as ptyalin), which begins the breakdown of carbohydrates.
What are the 4 anatomic regions of the stomach
- The cardia is the narrow portion of the stomach that is below the gastroesophageal (GE) junction.
- The fundus is the area nearest to the cardia.
- The main area of the stomach is referred to as the body or corpus.
- The antrum (pylorus) is the distal (lower) portion of the stomach and is separated from the duodenum by the pyloric sphincter.
What kind of cells secrete HCL?
- Parietal cells secrete HCL and Intrinisc factor (which aids in the absorption of B12. Absence of IF results in pernicious anemia)
- Chief cells secrete Pepsinogin
Describe the Endocrine and exocrine functions of the Pancreas.
- The exocrine part is about 80% of the organ and consists of cells that secrete enzymes needed for digestion of carbohydrates, fats, and proteins (trypsin, chymotrypsin, amylase, and lipase).
- The endocrine part of the pancreas is made up of the islets of Langerhans, with alpha cells producing glucagon and beta cells producing insulin.
What are the 3 main functions of the Liver
- Storage: Magnesium, Fat Soluble vitamins (ADEK), Iron
- Protection: the phagocytic Kupfer Cells that engulf harmful bacteria and anemic RBC
- Metabolism: breaks down amino acids to amonia, synthesizes several plasma proteins, including albumin, prothrombin, and fibrinogen, synthesizes, breaks down, and temporarily stores fatty acids and triglycerides, forms and secretes bile which is needed for digestion of fat.
What is the function of the gallbladderr?
collects, concentrates, and stores the bile that has come from the liver.
The abdomen is assessed by using what 4 techniques in what order?
What is Cullen's sign
- ecchymosis around the umbillicus
- This is a sign of internal bleeding
increasesd motility in the bowel
Elevations in amalyse and lipase may indicate....
What electrolyte is measured to help diagnose malabsorption in the GI tract?
Excessive Vomiting or diarrhea may deplete what 2 electrolytes and requires replacement
Sodium and Potassium
_________ and ________ are two enzymes found in the liver and other organs. These enzymes are elevated in most liver disorders, but they are highest in conditions that cause necrosis, such as severe viral hepatitis and cirrhosis.
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
What are to oncofetal antigens that help monitor cancer of the GI tract
CA19-9 and CEA
What should be avoided in a traditional FOBT?
raw fruits and vegetables and red meat. Vitamin C–rich foods, juices, and tablets must also be avoided. Anticoagulants, such as warfarin (Coumadin), and NSAIDs have to be discontinued for 7 days before testing begins.
How do you know if a pt aspirated during a feeding? What is the treatment for aspiration pneumonia?
- Listen to lungs and chest xray
- antibiotics and antipyretics
What helps dissolve coagulated tube feedings
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