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NR 324 Adult Health I Exam 3 Study Guide
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NR 324: Adult Health I Exam 3 Study GuideGastrointestinal:
Learning Objectives:
At the end of this class a student will be able to:
1. Define key terms related to Gastrointestinal system:
a. Borborygmi- Waves of loud, gurgling sounds
Hyperactive bowel as a result of eating
b. Hematemesis- Vomiting Blood
Esophageal varices, bleeding peptic ulcer
c. Melena- Abnormal black tarry stool, containing digested blood
Cancer, bleeding in the upper GI tract from ulcers, varices
d. Steatorrhea- Fatty, frothy, foul smelling stool
Chronic pancreatitis, biliary obstruction, malabsorption problems
e. Malnutrition- deficit, excess, or imbalance of essential nutrients.
It may occur with or without inflammation.
Imbalances in macronutrients (carbohydrates, proteins, fat) or micronutrients
(electrolytes, minerals, vitamins) occur with malnutrition.
Undernutrition describes a state of poor nourishment as a result of inadequate
diet or diseases that interfere with normal appetite and assimilation of ingested
food.
Overnutrition refers to the ingestion of more food than is required for body needs,
as in obesity.
f. Metabolic syndrome- AKA (syndrome X, insulin resistance syndrome, and
dysmetabolic syndrome):
Typically occurs in 60 years of age and older
S/S: including obesity, hypertension, abnormal lipid levels, and high blood
glucose
Waist circ: Men >40 cm, Women >35 cm
Triglycerides: >150 mg/ dL
HDL: Men > 40 mg/ dL, Women > 50 mg/ dL
BP: ≥ 130/85 mm HG or on HTN medication
Fasting Blood Glucose: ≥ 110mg/ dL or TX for high glucose
Complications: Patients with this syndrome are at a higher risk of heart disease,
stroke, diabetes, renal disease, and polycystic ovary syndrome
, Nursing interventions: Lifestyle modifications, reducing LDL cholesterol, stopping
smoking, lowering BP, and reducing glucose levels, weight loss, increase physical
activity, and healthy dietary habits.
g. Achalasia- absence of peristalsis of the lower two thirds (smooth muscle) of
the esophagus.
Rare, chronic disorder
Etiology: Pressure in the Lower Esophegeal Sphincter increases and then
incomplete relaxation
Results in obstruction of the esophagus or near the diaphragm.
Food and fluid accumulate in the lower esophagus= dilation of the lower esophagus
S/S: Dysphagia, chest pain during or after meal, night time regurgitation,
regurgitation of sour-tasting food and liquids when laying down, Halitosis (foul-
smelling breath), inability to eructate (belch), and weight loss.
Dx: esophagram (barium swallow), manometric evaluation (high-resolution
manometry), and/or endoscopic evaluation
Tx: treat symptoms, nitrates (isosorbide dinitrate [Isordil]) and calcium channel
blockers (nifedipine [Procardia]) taken sublingually 30 to 45 minutes before meals to
treat dysphagia, botulinum toxin endoscopically into the improves esophageal
emptying.
Surgical: Endoscopic pneumatic dilation, Heller myotomy, is done laparoscopically
h. Dysphagia- difficulty swallowing
2. Recall the basic mesisinalksen, Heitkemper, & Bucher:concepts related to
pathophysiology of the gastrointestinal system.
a. Differentiate the processes of ingestion, digestion, absorption, and
elimination
Ingestion- intake of food
Appetite center located in the hypothalamus: Directly or indirectly stimulated by
hypoglycemia, an empty stomach, decrease in body temperature, and input from
higher brain centers
Digestions: physical and chemical breakdown of food into absorbable substances.
Saliva= amalyse
Chief cells > pepsinogen > HCl acid > pepsin = breakdown of protein
Lipase: fat digestion
Intrinsic factor = absorption of cobalamin (B-12)
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