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Preview Vol2 Gastrointestinal

Preview Vol2 Gastrointestinal

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Published by greenflames09
notes from lecture, based from our professor and our school.. might be different from your system.. check it out, let me know how it is..

used to supplement books..

i never finished the series due to the workload that came up, i've always wanted to write study guides, make it exciting and easier, but that involves more studying, school, experience.. it's a process.. ^__^ who knows..
notes from lecture, based from our professor and our school.. might be different from your system.. check it out, let me know how it is..

used to supplement books..

i never finished the series due to the workload that came up, i've always wanted to write study guides, make it exciting and easier, but that involves more studying, school, experience.. it's a process.. ^__^ who knows..

More info:

Published by: greenflames09 on Sep 28, 2009
Copyright:Attribution Non-commercial No-derivs

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07/01/2013

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[1]
      M      E      D   -      S      U      R      G      E      2      0      0      7
Fall
 
Gastrointestinal System
It’s a huge chapter.WE CAN DO THIS!!!
FIRST EXAM!
Monday, October 8.GU and GI SystemsWe have no idea howthe exams are going tobe like. We’ll try ourbest!!
NCLEX QUESTIONS
included with answersand rationales.=)
 
GASTROINTESTINALSYSTEM
based on the lectures by Professor Erline Everett
[2]
GI ISSUES
We love to eat.
If something goes wrong.Eating will not be as fun.This is the story of Mr.Panini and his journey.His ups and downs,detours, mishaps, issues,and the road to recovery.You think you know, butyou have no idea.
 
GI Structure & FunctionStomach:
Secretions
hydrochloric acid kills bacteria
intrinsic factor essential for absorption ofVitamin B12
gastrin controls acidity
Sphincters
lower esophageal sphincter [LES]prevents reflux of stomach contents intoesophaguspyloric sphincter regulates emptying ofstomach into small intestine
Small Intestine:
d
uodenum,
 j
ejunum,
i
leum [DJ - I]
major digestion
accepts bile & pancreatic enzymes
Large Intestine:
ascending, transverse, descending,sigmoid, rectumfluid-electrolyte absorptionstool hardens as it gets closer to rectum
synthesizes Vit K, vitamins [some B]store house for stool
Gallbladder:
stores biledelivers bile to duodenum during fatmetabolism
Pancreas:
secretes pancreatic enzymes amylase,lipase, trypsin into duodenum to digest CHO[carbs], fats, proteinssecretes insulin hormonesecretes sodium bicarbonate toneutralize acidity of stomach nutrients
Liver:
contains Kupper’s cells that removebacteria in portal venous bloodremoves excess glucose & amino acidssythesizes glucose, amino acids, fatsaids in digestion of fats, CHO, proteinstores & filters blood [200-400 mL]sythesizes coagulation factors VII, IX, X,prothrombinstores vitamins A, D, E, K, B12, ironsecrets biledetoxifies chemicals [metabolism]promotes erythropoiesis duringinsufficient bone marrow production
Physical Assessment:
mouth - inspectionabdomen - inspection, auscultation,percussion, palpation
Assessment of Nutrition & DigestiveSystemDiagnostic tests:
serum proteins indicate nutritional status
 Albumin [3.5-5.0 gm]
increase = dehydrationdecrease = malnutrition, overhydration,protein loss, liver disease
Prealbumin [20-40 mg]
increase = renal failure
decrease = poor dietary intake
responds quicker to treatment
Transferrin [200-400 mg]
increase = pregnancy, iron deficiencydecrease = chronic infection, cirrhosis
Lymphocyte count [1500-4000]
indicates immune / nutritional statusTLC <1000 mL suggest malnutrition. Notaccurate affected by chemotherapy andsepsis
D-Xylose Absorption Test
indicates malabsorption in smallintestineNPO 10-12 hrsblood drawn in 2 hrs & urine collected in5 hrsbed rest activity affects resultsdecrease = malabsorption in smallintestine
Nitrogen Balance [4-6 gm positive]
indicates anabolic & catabolic state24 hr urine collectiondocument food intakenegative values = increase nutritionalneeds
Stool Analyses
test absorptive capacitycolor, shape, blood, fat [collect all stoolfor 24hrs], ova & parasitesspecimen for occult, culture & sensitivity[sterile swabs] - STAT labfoods affecting color:spinach - greencocoa - dark redsenna - yellowiron - blacktarry or black = upper GI bleedingbright red = lower GI bleedingavoid red meat, poultry, fish, turnips,horseradish 3days before collecting stoolsample for occult blood
Blood Chemistries:
serum amylase
determines secretion of amylaseassist in dx of pancreatitispeaks in 24hrs, drops to normal in48-72hrs
serum lipase
determine lipase secretion
stays elevated longer
Radiography:
Flat Plate of Abdomen
detects tumors, obstruction, free airnothing special [unless i missed it]
Upper GI Series [Barium Swallow]
visualizes esophagus, stomach,duodenum, jejunum
identifies structures, ulcers, tumors,polyps, hiatal herniaspre-op: NPO 6-8hrs, test lasts approx45minprocedure: pt drinks barium asfluoroscopy views passage [
 barium enemas and GB series are done first for lower GI 
]post-op: barium can cause constipation,abdominal distention - give laxatives. informpt to expect white stools 72hrs
Modified Barium Swallow[videofluoroscopy], Oropharyngeal Study 
used to evaluate swallowing
barium mixed with food of differenttexturs
observed by speech therapist orradiologist
pre-op: NPO
post-op: NPO until results aredetermined
[3]

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