1
Q
Cecum:
A
- Blind pouch which from the first part of the large intestines
- Located below the entrance of the ileum
- Repository for bacteria and other organisms to digest cellulose
2
Q
Cirrhosis
A
Severe disease of the liver usually associated with alcohol abuse, nutritional deficiency, poisoning or previous infection. Scar tissue replaces normal liver tissue.
3
Q
Constipation
A
Hard, dry stool usually occurring infrequently; may be caused by inactivity, poor diet, medication
4
Q
Diarrhea
A
Frequent, loose bowl movements
5
Q
Duodenum
A
- Food enters from the stomach
- Secretes enzymes, along with the pancreas, to emulsify the bile and lower the PH of the stomach content
6
Q
Dyspepsia
A
Indigestion, often caused by change in the amount of gastric secretions
7
Q
Fecal Impaction
A
The formation of a firm mass of feces in the distal colon or rectum. QMAs not permitted to check residents for this.
8
Q
GERD (Gastroesophageal Reflux Disease)
A
Reflux of gastric contents into the esophagus
9
Q
Hepatitis
A
Inflammation of the liver
10
Q
Ileum
A
-Raw digestive material enters from the jejunum
11
Q
Jejunum
A
- Food enters from the duodenum
- Products of digestion absorbed into bloodstream through venous and capillary system
12
Q
Parasite
A
An organism that lives within, upon or at the expense of another organism. Intestinal ones are found in the intestinal tract
13
Q
Pyorrhea
A
Inflammation of the gum and tooth sockets leading to loosening of the teeth
14
Q
Ulcer
A
Repeated irritation causes a sore in the lining of the stomach or duodenum
15
Q
Stomach
A
- “C” shaped organ
- Holds and mixes food with digestive juices
- Excretes enzymes, hydrochloric acid and other juices for digestion
- Peristaltic action churns and mixes food with gastric juices, breaking it down for absorption
- Food stays for approx. 3-5 hrs
- Empties into duodenum
16
Q
Small Intestine
A
- Includes duodenum, jejunum, ileum
- Approx. 1.5 inches indiameter and 20 ft long
- Contents reach large intestine approx. 3 hrs after stomach is emptied
- Unabsorbed food moves into large intestine by peristaltic action
17
Q
Large Intestine
A
- Approx. 1.5 inches in diameter and 5 ft long
- Moves food by peristaltic action towards the anus
- Water is absorbed from unused food
- Contents are stored until elimination from body through rectum as feces
18
Q
Rectum
A
End portion of large intestine
19
Q
Anus
A
Opening at the end of digestive tract for expelling feces
20
Q
Accessory Organs of GI system
A
Teeth, tongue, Salivary glands, Pancreas, Liver, Gallbladder
21
Q
Antacids (Action and Use)
A
Action: Neutralizes stomach acid; decreases the rate of gastric emptying; treats hyperacidity
Use: Peptic ulcer, used to treat heartburn, reflux esophagitis, gastritis, hiatal hernia
22
Q
Antacids (Nursing Considerations)
A
- May interfere with medication absorption thus should not be given simultaneously with other medications- wait 1-2 hours
- Effect is prolonged when med is taken with food
- Chart amount and consistency of stools
- Antiflatulance tabs must be chewed throroughly
23
Q
TUMS
A
ANTACID:
calcium salts
May cause constipation
24
Q
Amphojel, Rolaids
A
ANTACID:
aluminum salts
Constipation common
25
Milk of Magnesia
| Alternagel
ANTACID:
Magnesium Salts
Usually causes diarrhea
26
Maalox
Mylanta
Gelusil
Riopan
ANTACID:
Combination of magnesium and aluminum
Used to balance out the constipating laxative effect
27
simethecone (Mylicon)
ANTACID:
Antiflatulance agent that decreases gas formation and is often added to antacids or taken as a preventative
28
Anti-Ulcers (Action, Side Effects)
Action: Prevents the release of gastric acid to treat or prevent stomach and duodenal ulcers
Side Effects: Minor. High doses can cause confusion
29
Anti- Ulcers (Examples of Meds)
```
famotidine (Pepcid)
nizatidine (Axid)
ranitidine (Zantac)
cimetidine (Tagamet)
misoprostol (Cytotec)
pantoprazole sodium (Protonix)
```
30
Anti-Ulcers: (Other meds given before meals)
omeprazole (Prilosec)
sucralfate (Carafate)
lansoprazole (Prevacid)
esomerprazole magnesium (Nexium)- adheres to the ulcerated area
31
Anti-Ulcers: (Nursing Consideration)
- Dissolve Caragate tablet in water
- Encourage resident not to smoke (increases gastric acid secretion)
- Encourage resident to avoid: spicy food, caffeine, nicotine, alcohol and carbonated beverages
32
Antiemetics (Action, Use, Side Effects)
Action: Suppress nausea and vomiting by acting on the brain control center
Use: To treat nausea and to treat and prevent vomiting
Side Effects: Drowsiness
33
Antiemetics (Example meds)
```
dimenhydrinate (Dramamine)
trimethobenzamide (Tigan)
meclizine (Antivert)
prochlorperazine (Compazine)
promethazine hydrochloride (Phenergan)
```
34
Antiemetics (Nursing Considerations)
Monitor blood pressure for hypotension
35
Emetics (Action, Use, Nursing Considerations)
Example: Syrup of Ipecac
Action: Induce vomiting by acting on the brains control center
Use: Used when poison has been ingested
Nursing Considerations:
- Do not use when corrosive product ingested, such as acids or alkalies, or and/or if resident is drowsy or unconscious. The licensed nurse should contact the physician and/or poison control center before administering
- Usually induces vomiting 20-30 min after administration
36
Antidiarrheals
Medications that relieve diarrhea
Includes:
- Adsorbents
- Opiates
- Meds that alter motility
37
Adsorbents
Examples:
- kaolin
- bismuth (Pepto-Bismol)
- pectin (from apples)
- kaolin and pectin (Kaopectate)
Action: Adsorb (Soak up) excess fluids and bacteria
Used: to treat diarrhea
Side Effects: Minimal constipation, nausea, dry mouth and abdominal pain
Nursing Considerations: Monitor for constipation
38
Opiates
Example: opiates (Paregoric)
Medications that slow down intestinal motility
Action: Reduce peristalsis by action on central nervous system and diminishes secretions
Use: to treat diarrhea
Side Effects: drowsiness, may be addicting
39
Gastrointestinal meds that alter motility
Examples:
-atropine sulfate; diphenoxylate/atropine (Lomotil); Atropine; scopolamine; phenobarbital (Donnatal); kaolin; pectin; loperamide (Imodium); dicycomine (Bentyl)
Action:
-Acts on autonomic nervous system to alter peristalsis
Use:
-Spastic colon; diarrhea; GERD
Side Effects:
-Varied and many because of the effect on entire ANS
-Blurred vision; dry mouth; heart palpitations; urine retention; constipation
Nursing Considerations:
-Monitor vital signs and urinary output
40
metoclopramide (Reglan)
Enhances intestinal motility
Give before meals rather than with food
41
Cathartics
Laxatives
Categories:
- Laxatives which stimulate intestinal peristalsis
- Saline laxatives
- Lubricant laxatives
- Laxatives that moisten feces
- Bulk laxatives
- Lactulose
- Enemas
42
Castor oil
senna (Senokot)
bisacodyl (Dulcolax)
phenlphthalein (Ex-Lax, Doxidan)
- Laxatives which stimulate intestinal peristalsis
- Usually act in 6-8 hrs with PO form; Supp work faster
- Side Effects: abdominal cramping; nausea, diarrhea
- Nursing: Monitor for diarrhea
43
Milk of Magnesia
Saline Laxative
- Pulls fluid into the large intestine
- Acts within 8 hrs
- Side Effect: diarrhea, cramping
- Nursing: Monitor for good fluid intake following administration; Shake suspension well
44
Mineral oil
Haley's MO
gucerin suppository
Lubricant Laxative
Action: increases water retention in stool thereby stimulating evacuation
Side effects: interferes with absorbing nutrients; abdominal cramping; not for long term
Nursing considerations:
-May interfere with absorption of vitamins
-Administer mineral oil on empty stomach; works within 2-6 hrs; can give with fruit juice
-Glycerin- should be retained for at least 15 min for best results
45
```
ducusate calcium (Surfak)
docusate sodium (Colace)
calcium polycarbophil (Fiber Con)
```
Laxatives that moisten fecal matter
Action: Stool softener, used to promote regular bowel evacuations
Side Effects: Mild abdominal cramping; may cause diarrhea
Nursing Considerations:
-May take 1-3 days to soften stools
-If resident has a routine order for a laxative, stool softener or lubricant and is experiencing diarrhea, consult the nurse as to whether the med should be given
46
psyllium (Metamucil)
| methylcellulose (Citrucel)
Bulk laxatives
Action:
-Absorbs water and expands to increase bulk and moisture content of stool
-Acts within 12 hrs to 3 days
-Most natural, non-irritating method of relieving constipation
Side Effects:
-Nausea, vomiting, diarrhea with excessive use,
-esophageal, gastric, small intestine and rectal obstruction when med is taken in dry form
Nursing:
-Must be administered with at least 8 oz of liquid
-Encourage an additional glass of fluid
-Use sugar free formula for diabetes
47
Lactulose (Chronulac, Enulose)
Action: pulls fluid into the intestine, resulting in distention that promotes peristalsis. Used as a laxative and also in pts with liver disease
Side Effects: abdominal cramping, diarrhea and flatulence
Nursing:
-may dilute with water or fruit juice or give with food to minimize sweet taste
-store at room temperature
48
```
Enemas
sodium phosphates (Fleets Enema)
```
-A prepackaged disposable enema used to clean the bowel in preparation for tests
-Solution is hypertonic- draw fluid to the bowl
-Only enema a QMA can administer
Side Effects:
-abdominal cramping
Nursing Considerations:
-Cannot be administered on a resident who is dehydrated
-If resident has large hemorrhoids or anal excoriation, notify nurse so that he/she may assess resident before enema is administered
49
Fleets Enema administration technique
- Place resident in left Sim's side lying position
- Insert the pre-lubricated tip of the enema into the resident's rectum and install the solution at a slow steady rate
- Instruct the resident to hold the solution as long as possible for the best results
QMA
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