handout 4.2 (ch. 25) gastrointestinal.pptx

handout 4.2 (ch. 25) gastrointestinal.pptx - NURS 307 Week...

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NURS 307 Week 4 Alterations in Gastrointestinal Function Textbook chapters 25
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Anatomy and Physiology Stomach (LUQ) Contains hydrochloric acid , enzymes Pancreas (behind stomach) Secretes enzymes, electrolytes, bicarbonate to help digest fats, proteins, carbs Produces insulin, glucagon, gastrin Liver and gallbladder (RUQ) Secrete bile and bilirubin Metabolism of fat, protein, carbs Detoxification of hormones, drugs Storage of vitamins ADEK and glycogen
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Anatomy and Physiology Spleen (LUQ) Small intestine contains duodenum, jejunum, ileum Digests and absorbs carbs, amino acids, fats Covered with small villi to absorb Through diffusion and active transport Basic pH to facilitate metabolism and absorption Large intestine contains cecum, appendix, colon, rectum Reabsorption of fluid and electrolytes Excretes waste Bacteria synthesize vitamin K
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Pediatric Differences Absorption and excretion do not begin until after birth Small stomach capacity, increased peristalsis Small, frequent feedings ideal Frequent and liquid-y stools Relaxed cardiac sphincter leads to regurgitation Deficiency of amylase (carbs) lipase (fats) trypsin (protein) until 4-6 months Abdominal distention from gas common Immature liver function until 1 year Poor gluconeogenesis, protein/ketone formation, vitamin storage, deamination Able to control excretion at 18 months Fairly completely mature by 2 years, adjusts to TID meals
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Diagnostic Tests and Laboratory Procedures for the GI System (from table 25-1) Diagnostic procedures Laboratory tests Abdominal ultrasound Barium or contrast enema CT of the abdomen Endoscopy GI series Intraesophageal pH probe monitoring Abdominal radiographs Complete blood count Bilirubin Electrolytes Liver enzymes Stool for occult blood Stool for ova and parasites
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Cleft Lip and Palate Maxillary process fails to fuse properly Cleft lip in 1 out of 750-1,000 live births Union of upper lip completed by week 7 gestation, secondary palate fusion at 5-12 weeks gestation, hard and soft palates completed by 1 st trimester 30% of children will also have other congenital anomaly Genetic and environmental influences Folate intake may help prevention Cleft Lip Only; 20% Cleft Palate Only; 35% Cleft Lip and Palate; 45%
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Cleft Lip and Palate Apparent from birth May need help from plastic and oral surgery, audiology, speech/language pathology, otolaryngology, dentistry, genetics, social work, psychology (child and parent), lactation consultant Repair at 3-5 months Soft elbow restraints used postop to protect incision May affect feeding, may need longer nipples with enlarged holes
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Esophageal Atresia and Tracheoesophageal Fistula Foregut fails to lengthen, separate, and fuse into two parallel tubes (esophagus and trachea) at 4 to 5 weeks' gestation Associated with maternal polyhydramnios
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Esophageal Atresia and Tracheoesophageal Fistula Excessive salivation and drooling
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  • Summer '18
  • Gastroenterology, Gastroesophageal reflux disease, Vomiting, Crohn's disease

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