Kceanicngampckernouneatae rancerch i OME SEE ——— Me ele Smamemuenennse™ STUDENT'S ACTIVITY SHEET BS NURSING / THIRD YEAR sated aaa ie Nett) LESSON TITLE: REVIEW OF DIGESTIVE SYSTEM; pestartales SEE Te ett ocr, ck pen adios piper taatne streams Ce Renee eee wil 1, Review the anatomy end physiology of the gastrointestinal Sees a oe eet 2. dently the related pharmacology and dagnostc tests Medical Surglest Nursing 11 Ealtion ineot Willams Eins 5. eently the mecical management ofthe dsoréers Eippineolt Wee SUBJ TENTATION & GETTING TO KNOW EA A eee 2 Five- word biography 8 You wil now take nate everything abou tre subect orientation, 1. Calendar of activites 2 Classroom rules and regulations 3. Comautaton of grades 4. Grading of modules 5 Election of officers 5. Requremenis C. Review of Digestive System Terms to Remember 7 Gigettion. ll changes tat food undergoes Inthe alimentary canal so thatitcan be absorbed and metabolizes. Types: T Mechanical Digestion all movements ofthe slimentary act that changes the physical state of foods ard propel foods inthe alimertary tact. (eg. Chewing, Swalowing, Peristasiswavelke movement that Fhueeze tne food down, seqventa, onlections- movements that mbx intestinal contents with cigastve wees) + Chemical Digestion: series hyeroyte processes dependent on specfice Substance may be necestary 19 act as a calast to faciiate process (0.9. ig proteins, viaming, mineral, etc) 2 Absoration e Passage of substence through the inlestnal mucosa info the blood er lymph. ‘Aecomplsned mainly though he movement of molecules. 2 Mojonty occurs n he email intestine, most water 1s absorbed from he large intestine. 3 Metabotsm ‘This document and th information thereon is the property of PHINMA Eauestion (Depenment of Nursing) 1010 Scanned with CamScanner‘+ Sum of al the chemical reactions in the body + Anabolism- is the “building of compounds", which uses energy Catabolism. is the “breaking down of compounds" to release energy 4. Elimination + Removal of waste products through defecation =. + Occurs in the large intestines and rectum. fees Activity 1: Label the digestive system. 4 Nasa 7._Shomacty_ 2a e_Vaureat 3ataNiaany glad 8 eee inves hay 4 hays 1G IMAN_ntahnw Swan 11_Fedtem 6 leer 12._Aavd iy? Diem Ore Senay rors Sissi 6s | Quas’ Sam Buaversoene Q ssinwicere Gram —°G tos MAIN LESSON (1 hour and 25 minutes) ‘The students wil study and read their book about these lessons (Chapter 24 and 36 of the book). Chapter 34 DIAGNOSTIC EVALUATION ‘A. Serum Laboratory Studies 4.CBC 2. Liver function test 3. Amylase and lipase 4. Carcinoembryonic antigen (CEA) = to determine the stage and extent of the disease and the prognosis for those with cancer, especially Gl and, in particular, colorectal cancer 5. Cancer Antigen 19-9 - is a protein that exists on the surface of certain cells and is shed by tumor cells, making it useful as a tumor marker to foliow the course of the cancer. CA 18-9 levels are elevated in most patients with advanced pancreatic cancer. bi! they may also be elevated in other conditions such as colorectal, lung, and gall- bladder cancers, gallstones, Pancreatitis; cystic fibrosis; and ver disease. 6. Alpha-fetoprotein — for liver cancer B. Stool Test ~ Random specimens should be sent promptly to the laboratory for analysis; however, the quantitative 24- to 72- hour collections must be kept refrigerated unt trans- ported to the laboratory Fecal occult blood (FOBT) ~ is one of the most commonly performed stool tests and can detect occult blood in stools, indicating GI bleeding 'X can be useful in initial sereening for several disorders, although it is used most frequently in early cancer election program. Red meats, aspirin, vitamin C, nonsteroidal antiinflammatory orugs, turnips. and horseradish ‘should be avoided for 72 hours prior to the study, because they may cause a false-positwe resut ©. Breath Test his document and the information thereon is the propery of PHINMA 20f 10 Education (Department of Nursing) Scanned with CamScannerSALIVARY CALCULUS (SIALOLITHIASIS) : Salo ( i, of Salivary calculi (stones), us mainly from calcium phosphate. Clinical Manifestations 4. Swollen, tender gland 2. Pelpable stone 3, With obstruction: sudden, local, and often col- icky pain, which is abruptly relieved by a gush of saliva Diagnostic Test Salivary gland ultrasonography or sielography — to demonstrate obstruction of the duct by stenosis Medical Management 4. Stone extraction 2. Lithotripsy «a procedure that uses shock waves to disintegrate the stone. Lithotripsy requires no anesthesia, sedation, or analgesia. Side effects cen include local hemorrhage and swelling Surgical management Removal of the gland for repeated recurrence CHECK FOR UNDERSTANDING (15 minutes) The instructor will prepare 10-15 questions that can enhance critical thinking skills. Students will work by themselves to answer these questions and write the rationale for each question Multiple Choice (For 1-10 items, please refer to the questions in the Rationalization Activity) RATIONALIZATION ACTIVITY (DURING THE FACE TO FACE INTERACTION WITH THE STUDENTS) ‘The instructor will now rationalize the answers to the students and will encourage them to ask questions and to discuss among their classmates for 20 minutes, 1, You're performing an abdominal assessment on Brent who is 62 y.0. In which order do you proceed? ‘A. Observation, percussion, palpation, auscultation ‘Observation, auscultation, percussion, palpation Palpation, percussion, observation, auscultation ANSWER: _@ 7 1. : RATIO: Ww Wia_bv! Lo pai dla. ep hand —beev)= 2. While palpating a female client's right upper quadrant (RUQ), the nurse would expect to find which of the following structures? A Sigmoid colon B.Appendix Spleen Liver 3. A female client being seen in a physician's office has just been scheduled for a barium swallow the next day. The nurse syrites down which instruction for the client to follow before the test? Fast for 8 hours before the test Eal a regular supper and breakfast Lea SSD VILA ae OTE This document end the information thereon is the property of PHINMA Scanned with CamScannerPo 5. Apatient complains about which glendls? ‘suceal Parotie . Sublingual ©. Submandioular n pllamed salvary land below his nght ear. The nurse documents probsble inflammation of ANSWER. : 7 man RATIO: q . wana , os z thas the fouel_warpa 6 Paros caused by bactona is treatee with which of ne folownng cru classifications? A. Analgesies 3 Contosteroids Anipyreies nibiots ANSWER . . : RATIO 4 -peemetnni rip OME cere —the—eenbriarrse et tenia pith eke tae : 2 Viich ofthe follownng are the possible causes of sialaderis? Select all that apply Dehydration stress & Dental exraction Improper oral hygtene Frequent ingestion of cold beverages ANSWER B48 40 RATIO. A patient asks, “Is surgery alvays the treatment of choice for inflamed salivary glands? Your best response would be: ‘Yes. surgery is always the answer. '8 Surgery is only recommended for children. {&. Blaerl is not a candidate for parotidectomy. at - « i jy Meaty ture called A MATIN Mis He Outvie oniy ehane vlalkdenihs Gra J nemned fain - ‘Ths document and the informetion thereon is the property of PHINMA Eaucation (Department of Nursing) Sof 410 Scanned with CamScannerperch the floving condons described as presence of calculn the salvay glands? Parct Sialadenits D. Mumps, ANSWER: RATION glinaey Quek AROd Oe mage nyselallincd _mydeeals thal toc a the goes “retired pate ralivany duc} cotertog salivary calculus? £0. Which ofthe folowing Lihotriasy ‘Antibiotic therapy ©. Nephrectomy D. Endoscopy ANSWER: RATIO ig medical management is recommended fo tt ed Rr Rr he lede " Shed ang fished today in the wacker below. This is simply @ visual to help you You have accomplished and how much work there is lot toes, ‘You are done with the session! Let's track your progress ied [a Tes els] ee eae 1 Period ] Stel TsTetis Tas a sae TT Summary vonage ice ice edd) rie) aL) 7 ah di digerhve ‘Write the things you have learned in this lesson in the form ofa favori 4 fi ile te song, w We (a ai Bytom beck wh my dy : ah ead nigh “ne ate thy tas Agee cht ah Mall and tary, vba retin and ante gh tyecd digechintachee tea bern eae nee Seagh the teteus_Adlim—cnd atenghinn foaled ie Hayowwm ram Ha te deme “return, eine Bay? (ar ater eee tert amea veh ete eta Mee bag t dhminahen pamevar aly MEIER “aeenaien Yor vay GAA digteve 2 VC gee AN fate caw body ai at fad! “eat tan Aiease yoo gah Pargriky quelantatn ef para ainda ond Hed goa can eat marten ete at ot vate onde ae as free via Can deni ao Qa baby! information thereon is the property of PHINMA Education (Depertment of Nursing) 10 of 10 Scanned with CamScanner‘CARE OFCLIENTS WITH PROBLEM IN NUTRITION, AND GASTRO-INTERNAL, METABOLISM AND ENDOCRINE, PERCEPTION AND COORDINATION, (ACUTE ‘AND CHRONIC) BS NURSING / THIRD YEAR Session # 2(2 hours and 30 minutes) LESSON TITLE: GASTROINTESTINAL INTUBATION AND SPECIAL NUTRITIONAL MODALITIES; GASTRITIS, LEARNING OUTCOMES: Upon completion of this lesson, the nursing student can: ‘Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K. modalities. a i it |-Surgit * Edition. 2, Sate foods and other substances thal may cause ges Heer amesmane 3. Recognize nursing diagnosis related to the disorder, interventions to relieve pain. 4, Identify nursing (ena is LESSON REVIEW | PREVIEW OR Answer the questions below HOOK ACTIVITY (10 minutes) hat are the primary functions ofthe gastoitegtnl rat (Gryg ee descr gach saiel ane TSlcacaePeTenaage Ne ead LMT GALS TORRES TAS Tanai tnakenn be abeected | ZAbsorption- wecampwhecnt manly rhevigh matnent yf mate cule > mel 3. Elimination - Qewwat, rate vRavcl threngh Arte cahwn MAIN LESSON (1 hour and 56 minutes) Study and read your book about this lesson (Chapter 36 and 37 of the book) Chapter 36 GASTROINTESTINAL INTUBATION ‘Gastrcinlestinal (GI) intubation is the insertion of a flexible tube into the stomach, beyond the pylorus into the duodenum or the jejunum. The tube may be inserted through the mouth, the nose, of the abdominal wall. Indications: Te decompress the stomach and remove gas and fluid + Tolavage (flush with water er other fluids) the stomach and remove ingested toxins or other harmful materials + Tociagnose disorders of GI motlity and other disorders To administer medications and feedings + Te compress a bleeding site * To aspirate gastric contents for analysis, Tube Types. (Orogastric tube - a large-bore tube inserted through the mouth with a wide outlet for removal of gastric ‘contents; its used primar in the emergancy department or an intensive care setting, ‘Nasogastric (NG) tube such as the Sengstaken-Blakemore tube is used to treat bleeding esophageal varices A. Gastric Tubes This document and the information thereon is the property of PHINMA Education (Department of Nursing) 1 0f 13 Scanned with CamScannerNursing Management ehor z wv days— : apy is nec along with serum electrolyte values. Biter the symato’ 2d by clear liquids. Introduce sol oral nutrition, decrease the need for IV therapy, As food s that suggest @ repeat episode ofgastrtis b. Discourags ¢ caffeine is a central nervous system stimulant & Discourage alcohol use, and cgerette s ¢ nicetine reduces the secretion of pancreatic bicarbonate, which inhibits # ‘c acid in the duodenum 4. Initiate and sling and smoking cessation programs. 2, Promote Fluid Balance 2. Monitor daily fiuid intake and output to detect early signs of dehydration (minimal fluid intake of 1.5 Liday, minimal output of 20 mL/n), b. Iffood and oral fuids are withheld + Administer IV fluids (3 Liday) and a record of fluid intake Assess electrolyte values (sodium, potassium, chloride) every 24 hours to detect any imbalance & Observe for any indicators of hemorrhagic gastritis: hematemesis (vomiting of blood), tachycardia, and hypotension. = Notify the physician and monitor the patient's vital signs. 4. Relieve Pain b. ‘ ‘Avoid foods and beverages that may be irritating to the gastric mucosa, Instruct the patient about the correct use of medications to relieve chronic gastitis. Assess the patient’ level of pain and the extent of comfort achieved through the use of medications and avoidance of irtating substances, CHECK FOR UNDERSTANDING (20 minutes) ‘The instructor will prepare 10-15 questions that can enhance crtical thinking skills. Students will work by themselves to answer these questions and write the rationale for each question. Multiple Choice (For 1-15 items, please refer to the questions in the Rationalization Activity) RATIONALIZATION ACTIVITY (DURING THE FACE TO FACE INTERACTION WITH THE STUDENTS) ‘The instructor will now rationalize the answers to the students and will encourage them to ask questions and to discuss ‘among their classmates for 20 minutes. 1. Acute gastits is often caused by: ‘A. Ingestion of strong acids B.Inttating foods Overuse of Aspirin All of the abiove ANSWER: RATIO! : : mm = - aa This outa te intaton Peron ha Education (Department of Nursing) Se 10 of 13 Scanned with CamScanner“Netliha 4 Da ihlammabit etme gaccit_neroyatelpey_btoek_ttken rasa hig. fan Ope Anal “eranley. AKC came) der aspirin Oe nodal artiomtiam: PATIO \ARM Oona cae oy emit beac Meg ishbid grovlaglaadin wyndhe vot winch of the folowing, Vitamin O viamn rz vitamin C 1D Vitara E ANSWER. _Q. RETO ham —yovdewhtfosiedaetesntah The nurse mantors the clent, knowing that this client is at risk for to_and_athongng—ef dhe linitg ot the whmach_leads’ g =f AW 4 At netet of tha Dbl (uth —vdiorde of tne aL Leh tela Une Nt ig bli Ha beer —ale men — 8-4 - 5 The nurse 1s reviewing the medic jx Amoncitin (Amoxil) Indomethacin findecin) © Lansoprazele (Prevacid) D Glanthuomyesn (Bazin) en record of @ event with gastntis, Which medication, if noted en the elent's record, (Cempleling gastric resection . Trealing the underlying cause 1D. Administering enteral tube feedings ANSWER _A RATIO Which of the following treatments should be included in the immediate management of acute gastritis? Reducing work st25s ofthe folowing risk factors can lead to chroniegastrits? Young age Gyrmooonc usage '5 document and the information thereon is the property of PHINMA avon (Department of Mureing) 11 0f 13 Scanned with CamScanner2 a eget ken at og Pan: heh tat teaming sng OENOC) serbian by belramacite — i a %. Overproduction of stomach acid ©. Overproduction of vtamin B12 ANSI e weaboned whoweh hing Minding —i¢ vitamin Oe destiny and orepagetntiy permed aaenia> Monitor fluid intake and output daily to detect early signs of dehydre . Administer Amoxicilin (Amari twice 2 dy. D. Stan intravenous fluid therapy. ‘ANSWER: nauseated and vomited 10 times at home, whieh of the following nursing diagnoses is ‘ppropriate for this pationt? Select al that apply ‘A. Acute pain related to iitated stomach mucosa ‘Anxiety related to treatment Imbalonced nutrition, tess than body requirements related to inadequate intake of nutrients Risk for imbalanced ftuid volume related to insuticient fuid intake and excessive luidioss “ANSWER: RATIO eye-ehtted 4B ines carts —celated a4 taal paca Mare neuce Aled and vocntled rises le a—ndnn and —eovk bien nudes jthechaleel a, sae a Fapsebihy ad & wy the pry shelesica) vihahin 11. Michael 0 42 y.0, man's edmited to tne med-surg for witha ciognosis of acute pancreatitis. His BP is 18176, puse 88, Resps 22 and temp 101. bis past history includes hyperipidemia and alcohol abuse. The doclor presebes on NO cae cfre insoring the tube, you explain the purpose to patient Which of ihe following I @ most accurate evolonaon? itemplie the stomach of figs and gas" “it prevents spasms atthe sphincier of Oadi~ a. {rom forming in the small intestine and large intestine D.“itremoves bile from the galbladder." ANSWER’ RATIO:_aa, Mie whe y Utered nig tae Vahl shmach denies suid ¢hd gay 12 Jason. a 22 y.0, accident victim, requires an NG tube for feeding. What should you immediately do ater inserting ai IG tube for liquid enteral feedings? v ‘Aspirate for gastric secretions with a syringe, gin feeding slowly to prevent cramping, €. Get an X-ray ofthe tip ofthe tube within 24 hours. ©. Clamp off the tube until the feedings begin, “ANSWER: This document and the information thereon is the property of PHINMA Education (Department of Nursing) 12 of 13, Scanned with CamScannerAegean tie stheash saskals canems Cemech PlaccmeD . th deur Via oe victim, requires TPN. The rationale for TPN is to provide: olytes to the Body. by tne | route FY Supplementation vith iquid protein given between meals. ENSINER oo : RATIO. WR a quvea WN. » Satine feeding Mets t ss 4 Your patient has GI wack thal is Tonchionng, but has The imabily 16 swallow foods. Which is the preferred method of é i feeding for your patient? TPN oer NG feeding © Oral quid supplements ANSWER . kw * RATIO. quatuad tor Wt-qolient heute ina biliby guallad odY we tedingy ani op trCicd fed andedivine te Ghnach—thaugh thot 4 ta Levted paral feed — 86 49-geiy peau enhance Honey: 18, An inlubated patient is receiving continuous enteral feedings through a Salem sump tube at arate of 6Omihr. Gastric ‘esidvals have been 30-40ml when monitored Q4H. You check the gastric residual and espirate 220ml. What is your first responce to this fining? ‘A Nolily the dactor immediately. B Slop the feeding, and clama the NG tube Discard the 220m, and elamp the NG lube Gwve 2 prescribed Gi stimulant such as metoclopramide (Regan). ‘ANSWER RATIO. A paikia yeidal_aueh 2 heets a seedy pete ayo ocd ted Be gh LESSON WRAP-UP (5 minutos) ‘You wil now mark (encircle) the session you have fnished taday in the tracker below. This is simply a visual to help you track how much work you have accomplished ang how much work there is left to do, ‘You are done withthe session! Let's track your progress, i cami Paros | Petal 3 Petiad's i HO Tes Teo ae aT ve [area oo ae Pasa se PTT TSE] 324 Answer this 3 Thee things | learned 2 Two things tha like to learn more about 4.One question stil have jamrnyg, te x) be ramey, ns gioler fava Aha other Jub ) De caenhey tne Wvesing teers pai and manng~ee cee 4) b ames wna Fane that May cote gar hits: Y meeegnite pwaey dingne vie tletal The dae dre 2+ vdenhey fhe Aeteny IEE pig and > 6g4 a 409 Ths document and the information thereon isthe property of PHINMA Education (Department of Nursing) 13 of 13, a \ i Scanned with CamScannerCARE OFCLIENTS WITH PROBLEM IN NUTRITION, AND GASTRO.INTERNAL, METABOLISM AND ENDOCRINE, PERCEPTION AND COORDINATION, (ACUTE ‘AND CHRONIC) BS NURSING / THIRD YEAR Session #3 (2 hours and 30 minutes) Materials: DISEASE (GERD), AND PEPTIC ULCER DISEASE es ober andl nete rock: Brolector References: zhane cUTOORBE: Smeltzer, S., Bare, B., Hinkle, J, & Cheever, K, Upon completion of this lesson, the nursing student can: (cond nner eSuddarth’s Textbook of Medical-Surgical Nursing 11" Edition, 1. Enumerate the risk factorsicausative agents rae 2. State common signs and symptoms, Son icorn wl iams 2k 3. Identify nursing interventions related to the disorders, a ac rae RA EE) LESSON REVIEW / PREVIEW OR HOOK ACTIVITY (2 minutes) ‘The instructor will ask the students to answer the following below. Instruction: Identity the following conditions described below, Write A ~ for Achalasi D- for Peptic Uleer 4. A condition in which the upper part of your stomach bulges through an opening in your diaphragm: B. 2. It characterized by impaired peristalsis of smooth muscle of esophagus and impaired relaxation of lower esophageal sphincter. A 3. Its a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach: C 4 tis'an excovation or uleeraiion that penetrates the mucosal wall of the Gl tract: MAIN LESSON (thour and 58 minutes) The students will study and read their book about this lesson (Chapter 35 of the book). 8 - for Hiatal Hemia, C ~ for GERD, IMPAIRED ESOPHAGEAL MOTILITY Types: 3 Achalasia: characterized by impaired peristalsis of smooth muscle of esophagus and impaired relaxation of lower esophageal sphincter. 'b. Diffuse esophagesl spasm: non- peristaltic contraction of esophageal smooth muscle. Cause: er'.own —- Risk Factors 1. Infection 2 Heredity 3. Age - 40 years of age or older 4. Autoimmune disease Clinical Manifestations 1. Dysphagia ~ both liquid and solid 2 Sensation of food sticking in the lower portion of the esophagus RSA pe a a ea on ons cape pre REE a This document and the information thereon is the property of PHINMA Education (Department of Nursing) 1 of10 Scanned with CamScannerFluid intal meaitime 4. Meals should cortan mare ar © The patient can « of carbohyoretes {The patient should eat emailer but more frequent meals. erate intake low and avoid concentrated sources 9. Dietary supplements of vitarrins ang medium-chain triglycerides and injections of vitamin 812 and iron may be proscribed. hh Reduce the intake of fat and administer an antimotity medication (loperamide [Imodium]) may control steatrrhes CHECK FOR UNDERSTANDING (15 minutes) The instructor will ask the students to study and answer the case below. Situation: Mrs. Dela Cruz was admitted in the Medical Floor due to pyrosis, dyspepsia and difficulty of swallowing, 1 Based from the symptoms presented, Nurse Melinds might suspect A Esophagitis - Hiatal hernia + GERD ©._ Gastric Ulcer ANSWER. _. RATIO._erd ii Ve hauktind of gavieie ut Atndtnal gentendur into the, ephagu! cased by cinayestenl ett —teaphe geal uphinek = Pyaat tc hedribucn « dye pencia “gad dysphagia “preter dial ye he 2, What diagnostic test would confirm the type of problem Mrs. Cruz have? A. banum enema barium swaliow "colonoscopy D. lower Gl series ANSWER: as RATIO aca “ oper Glee —asvid cmsicm heed . Coder coay V ansthey 3 Mrs. Dela Cruz complainéd of pain and aifficully in swallowing, The terms are referred This document and the information thereon is the nennadi. xe ru se Scanned with CamScanner4 cola, coffee and tea 9 high fat, carbonated and caffeinated beverages ©. beer and green tea D._Allof the above ANSWER: _ 0 - PATIO: noi i wu a 5 trdveey ay vba Situation: Nurse Marishka isthe staff nurse assigned at the Emergency Department. During her shift, @ patient was rushed in tho ED complaining of severe heartbum, vomiting and pain that radiates to the flank. The doctor suspects gastric ulcer, 5. What other symptoms will validate the diagnosis of gastric ulcer? ‘A. ight epigastric pain 6 pain occurs when stomach is empty pete rp ta } ee eae shee : RATIO: iu Me Re vesal deur Yo -4_naer aie @ exteropy RATIO: ot nrg ti ol wr A ai enti a ice en tec eta a drag: tort i848 7. Peptic ulcer disease particularly gastric ulcer is thought fo be cause by which ofthe following microorgamisms? A E.coli H.pylort S. aureus D._K. pnuemoniae ‘ANSWER: < . RATIO: Agiabiar glen up dian Gy a Gactiod ferpunulble ty spel vice and ae a This document and the information thereon is the property of PHINIMA Education (Department of Nursing) Bof10 Scanned with CamScanner© She is for occult blood test: what specimen will you collect? A. Blood B Urine Stool ._ Gastric Juice ANSWER: J RATION (quQobed-jtaC_lMmo}—guine wh ica ket thal AUC he ya renue ap bude, eT eo Cite chotinen the uha)—qeriag lhe rey eemman—fert a pect sett Soph ath Lea a afe deny eddie ppeutren aly re eaieeted '9.What Diagnostic test will confirm Achalesia? A. Barium Swallow 5 X-ray Studies ‘Manometry Barium Enema ANSWER: RATIO:_Ieonemekey iv _dlmet glieagy yed b_cmitmn the deagnasé’ ep achasedtn thu bd) Bee tet eae 10 For Shing Hitt em, a areca renfesatons oxen A. Heartburn Halitosis Regurgitation D. Dysphagia ANSWER: _. F E . RATION RG,O asc all lagvipcakon mati Eegtatucn ua i id fart tf pera 2viphagea)—thabel being Sesnia the —chaiita left Bil fi © LESSON WRAP-UP (15 minutes) You will now mark (encircle) the session you have fished today inthe tracker below. This is simply a visual to help {you track how much werk you have accomplished and how much work there is lef to do. You are done with the session! Let's track your progress. = Period t Pefod Patod seas (OMS MOLE e Pe eew ae aaa as Da Taw nea a Ta Tass La | 26 [aT SST STD Review It ‘The instructor will ask the students to answer the questions. 1. State 2 nsk factors f6r achalasia and hiatal hernia b - sapr itn sinauoss equle thal coq hte abba apsve teil —oUaaladia_2_oe_fachee tiasog_ pal Ta may One wre. peeta8 “wAlen, da Wheany wah @ a feane ow eadade on Wie Wi Wks ein ay defehve atastnes ad Pe “vheay a 2. Difeentatsthe charectersice of requis food of achalasia and halal hema, uy Lhe may fotl tip feed and drt ty deh gone bed ‘ tvtime arent AON Ane CCHtHS I aad “Weglu) VIGIC RNG vo allang - One ur ademnal pain: This document and the information thoreon is ihe property of PHINMA Education (Department of Nursing) 9 of 10 Scanned with CamScanner3, When tested, what is the pH of esophagus in achalasia and hiatal hernia? ap iAH eusEM AHEAL pe toate jh 0 wa Ang” ce ‘1 ‘fr 4. Give Stleastt nud intenlention 67 achaissis BA nista NerRis, PUTS CORES wsthin FE yemay form The eegenning Gy the drag: wi Pa Maen Miut_shetd wo _od1 thogzaln Meng Mang ih vied to documty phil jegic add Reply wai : VORA cao aan a pe eA a Athi bud a_Lengvbon dun gl tecd) pe bde herp Lt an [Thus document and the formation green ist progasty of PriAMA Education (Depaninent of hucsing) 10 of 10 Scanned with CamScanner