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Gastrointestinal System
Lecture 14
GI tract
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Mouth 
Pharynx 
Esophagus 
Stomach 
Small intestine 
Large intestine
Esophagus
• Moves food via…
• Peristalsis
– “Alternating waves of
contraction and
relaxation”
Stomach
• Mixes food with gastric
juices 
– Chyme
• Pyloric sphincter
– Controls stomach
emptying
• Stomach empties
completely within 4-6
hours after a meal
Small intestine
• 3 areas
– Duodenum
• Pancreas enzymes +
• Bile
– Jejunum
– Ileum
• Almost all food, water,
vitamins and mineral
are absorbed out of
small intestines
Large Intestine
• AKA:
– Colon
Accessory organs
• Liver
• Gallbladder
• Pancreas
Liver & Gallbladder
• Produces bile
– Greenish
– Emulsifies fats
• Extra bile is stored in
the
– Gallbladder
• Bile flows into
– duodenum via
– bile duct
Pancreas
• Secretes enzymes for
food digestion
Nutrients
• “Substances in food
that are used by the
body for growth,
maintenance and
repair”
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Carbohydrates
Protein
Fats
Vitamins
Minerals
Water
Metabolism
• Chemical reactions that
happen in the cells in
order to sustain life
– Catabolism
• Breaking down structures
for fuel
• “Burning”
– Anabolism
• Combining simpler
molecules to build more
complex structures
• “Building”
Carbohydrates
• Simple (sugar)
– Sugar
– Fruits
• Complex (Starch)
– Grains
– Legumes
– vegetables
Carbohydrates
• Function
– Convert to glucose 
– ATP 
– Fuel for the cells
Proteins
• Composed of amino acids
• Complete proteins
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Milk
Meat
Fish
Poultry
• Plant proteins
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Legumes
Nuts
Grains
Cereals
Protein
• Function
– Vital for body structure
and function
– Building and rebuilding
of tissue
Assessment
• Height & weight
• Auscultate bowel
sounds
– All 4 quadrants
– Normal q 5-15 sec
• Palpate abdomen
Diagnostic Test
• Upper endoscopy
• Exam esophagus,
stomach, duodenum
and upper jejunum.
• Used to ID
– Swallowing difficulty
– Gastric reflux
– Ulcers
Upper Endoscopy: Nrs Care
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Fasting 8 hours
Conscious sedation
Remove dentures
Hold food until gag &
cough reflex return
• Warm saline gargles or
throat lozenges for
comfort
Colonoscopy
• Visual examination of
large intestine
• Used to
– Screen for cancer
– Remove polyps
Colonoscopy: Nrs Care
• Bowel prep
• Conscious sedation
Terms: N/V
• Anorexia
– Loss of appetite
• Nausea
– Vague, unpleasant
sensation of sickness or
queasiness
• Vomiting
– Forceful expulsion of
stomach contents
N&V interventions
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Self limiting
Hold food initially
Clear liquids
Dry foods
Ginger
Inserting an NGT
• Standard precaution
• Position
– High Fowler’s
• Measure
– Tip of nose
– Earlobe
– Distal sternum
Enteral Feeding
• HOB 30o
• Check tube placement
– 30 mL air
– Check residual
• Reinstill aspirated
contents
– > 100 mL GT
– > 200 mL NGT
• Notify MD
Enteral feeding
• 30 mL water flush
– a/
– p/
Stomatitis
• Inflammation of the
oral mucosa
Stomatitis: Nrs Care
• Oral care p/ eating
• Avoid alcohol based
mouthwashes
• High calorie & protein
diet
• Soft, lukewarm or cool
foods
• Small frequent meals
• Avoid spicy foods
Gastroesophageal Reflux Disease
• Backwards movement
of gastric content
• GERD
• S&S
– Heartburn
– Sore throat
– hoarsness
GERD: Nrs Care
• Avoid lying down (3 hr)
p\ meals
• HOB up 6 inches
• Avoid alcohol and
tobacco
• Weight loss promotion
• Avoid acidy foods
• Administer meds
– Histamin-2 receptor
blockers
Peptic Ulcer Disease (PUD)
• Break in the mucous
lining of the stomach or
duodenum where it
comes in contact with
gastric juice
PUD – S&S
• Pain
– Burning, aching, ungerlike
– Relieved by eating
– Heartburn
• Elderly
– No symptoms
PUD - complications
• Hemorrhage
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Hematemesis
Orthostatic hypotension
Occult stool
Fatigue, weak
• Obstruction
– Feel full
– N&V
• Perforation
– Severe pain
– No BS