Assessing%20Clients%20with%20Nutritional%20and%20Gastrointestinal%20Disorders - PowerPoint PPT Presentation

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Assessing%20Clients%20with%20Nutritional%20and%20Gastrointestinal%20Disorders

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Assessing Clients with Nutritional and Gastrointestinal Disorders Chapter 24 NCLEX Questions The client s temperature rises to 100.4 on the first postoperative day ... – PowerPoint PPT presentation

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Title: Assessing%20Clients%20with%20Nutritional%20and%20Gastrointestinal%20Disorders


1
Assessing Clients with Nutritional and
Gastrointestinal Disorders
  • Chapter 24

2
Nutrients
  • These are found in food and used by the body to
    promote growth, maintenance and repair
  • 6 Categories
  • carbohydrates -vitamins
  • protein -minerals
  • fats -water

3
Carbohydrates
  • Sugar and starches
  • Grains (Whole wheat)

4
Proteins
  • Animal products
  • Milk
  • Soy
  • Bean

5
Fats - Lipids
  • Minimal amounts

6
Vitamins
  • Fruits and vegetables
  • Green leafy vegetables

7
Minerals
  • Minerals are found in all foods
  • vegetables, nuts, milk and some meats

8
Anatomy and Physiology
  • Gastrointestinal Tract
  • mouth
  • pharynx
  • esophagus
  • stomach
  • intestine

9
Stomach
  • Cardiac region, fundus, body, pylorus
  • Gastric glands- Parietal, chief,
  • Mucous, and Enteroendocrine.
  • 4-6 hours stomach to empty.
  • The nervous system controls
  • Gastric secretion.
  • Pyloric sphincter -Emptying

10
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11
Small Intestine
  • 3 Regions
  • duodenum
  • jejunum
  • ileum
  • Function
  • chemical digestion and absorption of food

12
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13
Accessory Digestive Organs
  • Liver and Gallbladder
  • Pancreas

14
Liver and Gallbladder
  • Function
  • secretes bile
  • stores fat-soluble vitamins (A, E, D K)
  • metabolizes bilirubin
  • stores and releases blood, iron and copper,
    glucose
  • synthesizes clotting factors (I, II, VII, IX, X)

15
Liver Disease
16
Pancreas
  • Function
  • produce enzymes that aid in digestion of fats
  • Lipase - promotes fat breakdown and absorption
  • Amylase - completes starch digestion
  • Trypsin - assists in protein digestion

17
Health Assessment Interview
  • What is your usual dietary intake?
  • Describe what you believe is a healthy diet
  • Have you had any episodes of indigestion, nausea,
    vomiting, diarrhea or constipation?

18
The Physical Assessment
  • Preparation
  • anthropometric measurements
  • height and weight
  • compare to ideal body weight (IBW)
  • usual body weight
  • triceps skin fold thickness (TSF)
  • measure mid-arm circumference (MAC)

19
Physical Assessment
  • Inspection
  • mouth
  • lips, tongue, buccal mucosa,
  • teeth, gums throat, breath
  • abdomen
  • skin integrity, venous pattern, pulsations

20
Abdominal Drapping
21
Inspection, what do you see?
22
Physical Assessment
  • Auscultation
  • all 4 quadrants, begin in the rt lower quadrant
  • Percussion
  • using your hands to illicit a sound
  • normal tympany is heard over the abdomen
  • dullness over organs (liver and spleen)

23
Abdomen
24
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25
Physical Assessment
  • Palpation
  • in all 4 quadrants
  • circular motion, first light, then deep
  • pain?
  • guarding?
  • masses?

26
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27
Abdominal Palpation
28
GI Changes with aging
  • Changes in GI function associated with aging can
    have a significant effect on nutrition, health
    and well-being.
  • Periodontal disease-Disease of the supporting
    structures of the teeth common cause of tooth
    loss in older adults. Result of poor dental
    hygiene lack of access to fluoridated water and
    genetics.
  • See textbook.

29
NCLEX Questions
  • The nurse caring for a client with dry mouth
    knows that this can affect the clients nutrition
    because
  • A. the client needs to drink more water during a
    meal

30
NCLEX Questions
  • B. digestion begins in the mouth
  • C. foods are likely to taste stronger
  • D. the client will eat more candy to stimulate
    saliva.

31
NCLEX questions
  • A client is ordered to be on a low sodium diet.
    The nurse is teaching this client about foods
    that are allowed in their diet. Which food item
    would the Nurse instruct the patient to consume.
  • A. Tomato soup
  • B Summer squash

32
NCLEX Questions
  • C. Instant oatmeal
  • D. Boiled shrimp

33
NCLEX questions
  • A client loses a significant portion of the small
    intestine as a result of a gunshot wound. The
    nurse caring for the client knows that this is
    likely to affect
  • A. the absorption of most nutrients from food
  • B. the ability to form a solid stool mass
  • C. secretion of hydrochloric acid
  • D. conjugation and elimination of bilirubin

34
NCLEX Questions
  • The clients temperature rises to 100.4 on the
    first postoperative day following abdominal
    surgery. The nurse interprets this to be
  • A. indicative of a wound infection
  • B. a normal physiological response to the trauma
    of surgery
  • C. suggestive of a urinary tract infection
  • D. an indication of overhydration

35
NCLEX
  • A client has had a liver biopsy. After the
    procedure, the nurse should position the patient
    on the right side. What is the primary reason
    for this position?
  • A. to immobilize the diaphragm
  • B. to facilitate full chest expansion
  • C. to minimize the danger of aspiration
  • D. to reduce the likelihood of bleeding

36
NCLEX Questions
  • An adult has a nasogastric tube in place. Which
    nursing action will relieve discomfort in the
    nostril with the NG tube?
  • A. Remove any tape and loosely pin the NG tube to
    his gown
  • B. Lubricate the NG tube with viscous lidocaine
  • C. Loop the NG tube to avoid pressure on the
    nares
  • D. Replace the NG tube with a smaller diameter
    tube

37
NCLEX Questions
  • A low-residue diet is ordered for a client.
    Which food would be contraindicated for this
    person?
  • A. Roast beef
  • B. Fresh peas
  • C. Mashed potatoes
  • D. Baked chicken
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