Lecture notes
GI disorders
- Module
- Institution
GI disorders -MEDSURG
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D.RevillExam
3
Key
Points
ch
45:
GI
Disorders
A & P
R e v i e w :
F u n c t i o n s
o f
O r g a n s
The
Digestive
System
Consists
of
mouth,
pharynx,
esophagus,
stomach,
small
intestine,
large
intestine,
and
anus.
Behind
the
stomach
is
the
common
bile
duct.
This
connects
the
liver
and
pancreas
Accessory
organs
aid
in
digestion
-
Liver
(produces
bile)
-
Gallbladder
(bile
storage)
-
And
pancrea
s
-
Connect
to
the
duodenum
Small
Intestine
-
90%
of
digestion
take
place
in
small
intestin
e
-
Bile
and
pancreatic
juices
enter
the
duodenum
Large
intestine
-
Completes
the
absorption
of
water,
manufacture
of
certain
vitamins
(vitamin
K
and
B7)
-
Vitamin
K
is
needed
for
normal
blood
clotting
-
Formation
of
feces
-
Excretion
of
feces D.Revill
Liver
(RUQ)
-
Largest
organ
-
Production
of
bile
-
bile
is
necessary
for
the
emulsi cation
of
fats
-
Managing
blood
coagulation
-
Metabolizing
proteins,
fats,
and
carbohydrates
-
Manufacturing
cholesterol
-
Manufacturing
albumin
to
maintain
normal
blood
volume
-
Filtering
out
RBC
and
bacteria
-
Detoxifying
poisons
like
alcohol,
nicotine,
and
drugs
-
Converting
ammonia
to
urea
-
Providing
main
source
of
body
heat
at
rest
-
Storing
glycogen
for
later
use
-
Activating
vitamin
D
-
Breaking
down
nitrogenous
waste
(from
protein
metabolism)
to
urea,
which
kidenys
can
excrete
as
waste
from
the
body
-
No
protein
for
patient
with
liver
disease
because
liver
cannot
detoxify
protein
which
will
turn
into
ammonia
and
will
stay
at
a
high
level.
If
client
has
intracranial
pressure,
ammonia
levels
will
rise
and
cause
straining
leading
toa
rupture
of
a
blood
vessel.
-
Goal
of
a
nurse
is
to
prevent
them
from
rupturing
a
blood
vessel
so
lactulose
is
given
to
help
aid
with
removing
ammonia.
Lactulose
is
also
used
t o
r educe
the
amount
of
ammonia
in
the
blood
of
patients
with
liv er
disease.
It
works
b y
dr awing
ammonia
fr om
the
blood
int o
the
colon
wher e
it
is
r emo v ed
fr om
the
body
-
A
lot
of
protein
(chicken,
meat,etc.)
turns
into
ammonia
and
not
be
able
to
be
excreted
through
urine
and
will
stay
in
kidneys
causing
toxicity
Liver
Considerations
➢
Album in
norm al
range:
3.5-5.g/dL
of
blood
○
<
L e s s
t h a n
3 . 4
m a y
i n d i c a t e
l i v e r
d i s e a s e
o r
a n
i n fl a m m a t o r y
d i s e a s e
○
<
L e s s
t h a n
3 . 4
a l b u m i n
l e v e l
m e a n s
m a l n u t r i t i o n
➢
Am m onia
norm al
range
15-45
m cg/dL D.Revill
○
I f
a m m o n i a
l e v e l s
a r e
H I G H
>
t h a n
4 5 m c g
m a y
c a u s e
I n t r a c r a n i a l
p r e s s u r e
○
L a c t u l o s e
h e l p s
w i t h
r e m o v i n g
a m m o n i a
.
T h i s
i s
g i v e n
t o
a i d
i n
r e d u c i n g
a m m o n i a
l e v e l
Gallbladder
and
Pancreas
➔
G a l l b l a d d e r ’ s
p r i m a r y
f u n c t i o n
i s
t o
s t o r e
b i l e
➔
The
g a l l b l a d d e r
i s
o n l y
f o r
s t o r a g e
,
the
c l i e n t ’ s
l i v e r
w i l l
s t i l l
p r o d u c e
t h e
b i l e
n e e d e d
f o r
d i g e s t i o n
. D.Revill
➔
Small
amounts
of
bile
will
continuously
enter
the
duodenum
and
perform
various
functions
➔
B i l e
i s
a
p r o d u c t
o f
t h e
l i v e r
a n d
a i d s
i n
t h e
d i g e s t i o n
o f
f a t s
P a n c r e a s :
p r o d u c t i o n
o f
p a n c r e a t i c
j u i c e
( d i g e s t i v e
e n z y m e s )
-
If
there’s
damage
to
the
pancreas,
pancreatitis
will
develop.
This
disease
messes
around
with
insulin
production.
S P L E E N
-
T h e
s p l e e n
d e s t r o y s
o l d
b l o o d
c e l l s .
The
spleen
also
filters
antigens
and
stores
platelets.
A
client
with
a
spleen
removed
is
at
increased
risk
of
infection
and
sepsis
due
to
reduced
immune
function
Endoscopy
-
Enables
direct
visualization
of
a
particular
hollow
organ
or
cavity
using
a
long,
flexible
fiberoptic
scope
(lighted
tube)
-
These
s c o p e s
h e l p
v i s u a l i z e
t h e
e s o p h a g u s ,
s t o m a c h ,
a n d
d u o d e n u m
for
routine
screenings
as
well
as
for
e x a m i n a t i o n s
o f
:
-
t u m o r s
-
v a r i c e s
(abnormally
enlarged
veins)
-
m u c o s a l
i n f l a m m a t i o n
-
h i a t a l
h e r n i a s
-
-
-
-
-
p o l y p s
(tissue
growths
projecting
from
a
mucous
membrane
-
u l c e r s
-
H e l i c o b a c t e r
p y l o r i
-
s t r i c t u r e s
(narrowings)
-
a n d
o b s t r u c t i o n s
T h e
e n d o s c o p e
a l s o
c a n :
-
obtain
tissue
specimens
for
biopsy
or
culture
to
determine
the
presence
of
H .
p y l o r i
-
Remove
polyps
-
C o a g u l a t e
s o u r c e s
o f
a c t i v e
G I
b l e e d i n g
-
And
perform
s c l e r o t h e r a p y
o f
e s o p h a g e a l
v a r i c e s
(injection
of
a
solution
into
the
vein
causing
it
to
shrink
and
eventually
disappear)
-
Areas
of
narrowing
can
be
dilated
by
endoscope
or
by
passing
a
dilator
through
the
scope
T y p e s
o f
E n d o s c o p i e s
-
C o l o n o s c o p y
-
E s o p h a g o g a s t r o d u o d e n o s c o p y
( E G D )
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