Anatomy and Physiology of the GI System, Disorders of the GI System, Intestinal Obstruction and Fecal Incontinence.

1. Chapter 45
Care of the Patient With a
Gastrointestinal Disorder

2. Lesson 45.1: Anatomy and Physiology
of the Gastrointestinal System
1. List in sequence each of the parts or
segments of the alimentary canal and
identify the accessory organs of digestion.
2. Discuss the function of each digestive and
accessory organ.
3. Discuss the laboratory and diagnostic
examinations associated with the
gastrointestinal system.
4. Identify nursing interventions associated with
disorders of the gastrointestinal tract.
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3. The Digestive System
 Consists of the digestive tract
 A muscular tube that extends from the mouth to
the anus
 Consists of the mouth, pharynx, esophagus,
stomach, small intestine, large intestine, and anus
 Accessory organs aid in digestion
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4. Organs of the Digestive System
 Mouth
 Pharynx
 Esophagus
 Stomach
 Small intestine
 Large intestine
 Anus
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5. Accessory Organs of the Digestive
System
 Liver
 Gallbladder
 Pancreas
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6. Laboratory and Diagnostic
Examinations
 Upper gastrointestinal series (upper GI, UGI)
 Tube gastric analysis
 Esophagogastroduodenoscopy (EGD, UGI
endoscopy, gastroscopy)
 Barium swallow
 Examination of stool for occult blood
 Colonoscopy
 Stool culture
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7. Lesson 45.2: Disorders of the
Gastrointestinal System (Part I)
5. Explain the etiology and pathophysiology,
clinical manifestations, assessments,
diagnostic tests, medical-surgical
management, and nursing interventions for
the patient with disorders of the mouth,
esophagus, stomach, and intestines.
6. Identify nursing interventions for
preoperative and postoperative care of the
patient who requires gastric surgery.
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8. Disorders of the Mouth
 Dental plaque and caries
 Candidiasis
 Carcinoma of the oral cavity
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9. Disorders of the Esophagus
 Gastroesophageal reflux disease (GERD)
 Carcinoma of the esophagus
 Achalasia
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10. Disorders of the Stomach
 Gastritis
 Peptic ulcer disease
 Cancer of the stomach
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11. Gastric Surgery
 Medical management for cancer of the
stomach
 Dumping syndrome is a possible complication
 Radiation
 Chemotherapy
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12. Lesson 45.3: Disorders of the
Gastrointestinal System (Part II)
7. Compare and contrast the inflammatory bowel
diseases of ulcerative colitis and Crohn’s
disease.
8. Identify nursing interventions for the patient with
a stoma for fecal diversion.
9. Discuss the etiology and pathophysiology,
clinical manifestations, assessment, diagnostic
tests, medical management, and nursing
interventions for the patient with acute
abdominal inflammations (appendicitis,
diverticulitis, and peritonitis), for the patient with
hernias, and for the patient with colorectal
cancer.
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13. Inflammatory Bowel Disease
 Ulcerative colitis
 Crohn’s disease
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14. Nursing Interventions for the Patient
with a Stoma
 Assess skin integrity
 Assess for allergies to powders or adhesive
 Provide education on changing pouch
 Assess peristomal area for infection
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15. Acute Abdominal Inflammations
 Appendicitis
 Diverticulitis
 Peritonitis
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16. Hernia
 External hernia
 Hiatal hernia
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17. Colorectal Cancer
 Second leading cause of cancer deaths
 Most growths found in the sigmoid and rectal
regions of the colon
 Cause remains unknown
 Risk factors include
 Adenomatous polyps
 Ulcerative colitis
 Diverticulitis
 Heredity
 Clinical manifestations are usually nonspecific
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18. Lesson 45.4: Intestinal Obstruction and
Fecal Incontinence
10. Differentiate between mechanical and
nonmechanical intestinal obstruction,
including causes, medical management, and
nursing interventions.
11. Explain the causes, medical management,
and nursing interventions for the patient with
fecal incontinence.
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19. Intestinal Obstruction
 Mechanical obstruction: caused by an occlusion
of the lumen of the intestinal tract
 Nonmechanical obstruction: caused by
something that decreases the muscle action of
the bowel (may be neurologic or vascular
disorders)
 Early phases of mechanical obstruction:
auscultation of the abdomen reveals loud,
frequent, high-pitched sounds
 In later stages, bowel sounds will likely be absent
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20. Fecal Incontinence
 Has a variety of causes
 The external sphincter may be relaxed
 Voluntary control of defecation may be disturbed
 Distention of the rectum
 Paralysis
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