Assessment of Digestive and Gastrointestinal Function

Thirty-eight. Assessment of Digestive and Gastrointestinal Function

LEARNING OUTCOMES

On completion of this chapter, the learner will be able to:

One. Describe the structure and function of the organs of the gastrointestinal tract.

Two. Explain the mechanical and chemical processes involved in digesting and absorbing nutrients and eliminating waste products.

Three. Discriminate between normal and abnormal assessment findings of the gastrointestinal system.

Four. Recognize and evaluate the major symptoms of gastrointestinal dysfunction by applying the patient's health history and physical assessment findings.

Five. Identify the diagnostic tests used to evaluate gastrointestinal tract function and related nursing implications.

NURSING CONCEPTS

absorption: phase of the digestive process that occurs when small molecules, vitamins, and minerals pass through the walls of the small and large intestine and into the bloodstream amylase: an enzyme that aids in the digestion of starch anus: last section of the gastrointestinal tract; outlet for waste products from the gastrointestinal system chyme: mixture of food with saliva, salivary enzymes, and gastric secretions that is produced as food passes through the mouth, esophagus, and stomach digestion: phase of the digestive process that occurs when digestive enzymes and secretions mix with ingested food and when proteins, fats, and sugars are broken down into their component smaller molecules dyspepsia: indigestion; upper abdominal discomfort associated with eating elimination: phase of the digestive process that occurs after digestion and absorption, when waste products are evacuated from the body esophagus: collapsible tube connecting the mouth to the stomach, through which food passes as it is ingested hydrochloric acid: acid secreted by the glands in the stomach; mixes with chyme to break it down into absorbable molecules and to aid in the destruction of bacteria ingestion: phase of the digestive process that occurs when food is taken into the gastrointestinal tract via the mouth and esophagus intrinsic factor: a gastric secretion that combines with vitamin B twelve so that the vitamin can be absorbed large intestine: the portion of the gastrointestinal tract into which waste material from the small intestine passes as absorption continues and elimination begins; consists of several parts-ascending segment, transverse segment, descending segment, sigmoid colon, and rectum (synonym: colon)

lipase: an enzyme that aids in the digestion of fats microbiome: the collective genome of all microbes in a microbiota microbiota: the complement of microbes in a given environment pepsin: a gastric enzyme that is important in protein digestion small intestine: longest portion of the gastrointestinal tract, consisting of three parts -duodenum, jejunum, and ileum-through which food mixed with all secretions and enzymes passes as it continues to be digested and begins to be absorbed into the bloodstream stomach: distensible pouch into which the food bolus passes to be digested by gastric enzymes trypsin: enzyme that aids in the digestion of protein

Abnormalities of the gastrointestinal tract are numerous and represent every type of major pathology that can affect other organ systems, including bleeding, perforation, obstruction, inflammation, and cancer. Congenital, inflammatory, infectious, traumatic, and neoplastic lesions have been encountered in every portion and at every site along the length of the gastrointestinal tract. As with all other organ systems, the gastrointestinal tract is subject to circulatory disturbances, faulty nervous system control, and aging.

Apart from the many organic diseases to which the gastrointestinal tract is susceptible, many extrinsic factors can interfere with its normal function and produce symptoms. Stress and anxiety, for example, often find their chief expression in indigestion, anorexia, or motor disturbances of the intestines, sometimes producing constipation or diarrhea. In addition, factors such as fatigue and an inadequate or abruptly changed dietary intake can markedly affect the gastrointestinal tract. When assessing and educating the patient, the nurse should consider the variety of mental and physical factors that affect the function of the gastrointestinal tract.