Digestion:
● Religious/cultural considerations:
○ Judaism and islam: no pork or shellfish
○ Buddhism and hinduism: vegetarian diet
○ Muslims fast sunrise to sunset during ramadan
■ Increased w of peptic ulcer/gerd
■ Ppi’s and H2 blockers may help
■ Puts diabetic patients at risk
● Upper GI/barium swallow:
○ Npo (8-12 hr adults) (4-6 hr kids)
○ No smoking, narcotics, or anticholinergics for 24 prior
● Colonoscopy: every 10 yrs at 45-75 (if in good health)
○ Pre: bowel prep, npo
○ Post: check vitals, rectal tube care in needed
○ Nurse in gi: ensure IV access (flush) and check baseline vitals
● Endoscopy: every 2 yrs 45-74
○ Atleast 2 days after GI or barium swallow due to barium drink
○ Prep: npo (6-8 hr adult) (4-6 hr kid), remove dentures/piercings/etc,
baseline vitals
○ Post: vitals and must check gag reflex
○ Can diagnose: gerd, hiatal hernia, cancer (barettesophagus)
● CT scan:
○ Must have IV access and know BUN, Cr
○ Have to check for iodine, shellfish, and contrast allergies
● Amylase: diagnose acute pancreatitis: peaks 24 hr after illness start and drop to
normal after 48-72 hr, so can be hard to catch
○ Digests carbs
● Lipase: digest fats
○ Diagnosis pancreatitis: should fast for 8-12 hr prior
● Bland diet:
○ B: bananas
○ R: rice
, ○ A: applesauce
○ T: toast
○ Can also do broth, mashed potatoes, saltines
● SMALL FREQUENT MEALS: 2 ½-3 hours
● With bad digestion, n/v:
○ Integumentary system (hair, skin, nails):
■ Brittle, falling out, bruised easily
○ Eyes: jaundice, pale sclera, sunked eyes
○ Nervous: hyperrelfexia, tremors, n/t circum oral, chvostek/trousseua sign
○ Musk: weak, fatique
○ <3: tachycardia, hypotension, dyssryhtmias
○ GI: BM, pain, abd pain/upset
Gerd:
ADULTS:
● Risk:
○ Obesity, tight clothes, smoking, etoh, hiatal hernia, and pregnany
(pressure on abd)
● Manifestations:
○ Regurgitation, dysphagia, atypical chest pain ( <3 burn most
common), sore throat, tooth erosion, hoarseness, narrowing of
esophagus, barretts esophagus (pre-cancerous)
○ Can also get sour taste, wheezing, or excessive salivating
PEDIATRICS:
● Manifestations:
○ Dry cough, asthma s/s, sore throat, recurrent pneumonia,
dysphagia, and irritable/arch back with feedings
● Risks: premature, male, neurological impairments, trisomy 21,
bronchopulmonary, dysplasia, and esophageal atresia
● Prevention/education:
○ Small frequent meals - 2 ½-3 hours
○ Avoid foods that ↑ stomach acid (aciditic, spicy, coffee, chocolate,
fat foods, fried foods)
○ Avoid eating close to bed
○ Elevate HOB
○ Loose clothes
