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What makes up the GI system?
- Mouth
- Esophagus
- Stomach
- Liver
- Gall bladder
- Spleen
- Small Intestine
- Large Intestine
- Rectum
- Anus
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Function of the GI Tract
- breakdown food into molecular form for digestion
- absorption of nutrients by digestion
- elimination of undigested food and other waste products
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What makes up the GU system?
- kidneys
- ureters
- bladder
- urethra
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Function of the GU system
- maintain the body's state of homeostasis by regulating fluid and electrolytes
- removing wastes
- providing hormones that are involved in rbc production, bone metabolism and hypertension
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Peristalsis
involuntary, progressive wave-like movement of the musculature of the GI tract
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Paralytic ileus
Paralysis of intestinal peristalsis
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Peritonitis
inflammation of the peritoneum
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Flatulence
excessive formation of gases in the GI tract
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Epigastric Pain
pain in the upper central region of the abdomen
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Rectum
the final straight portion of the large intestine
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Anus
opening at the end of the anal canal
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Sphincter
circular muscle that constricts a passage or closes a natural orifice
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Striae
irregular areas of skin that look like bands, stripes, or lines; stretch marks
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Health Promotion/Prevention for GI&GU systems
- Routine physical exam
- Nutritional status
- Colon & Rectal Cancer Screening
- Urinalysis test to detect diabetes, renal problems, infections
- Pap smear
- Testicular exam
- PSA prostate spedific antigen
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Health History of GI/GU systems
- Risk factors
- Surgical history (abdominal surgery, trauma)
- Medications, diet and alcohol
- Family history
- Bowel/bladder habits
- Aids to elimination, either physical or chemical
- Weight changes
- Abdominal/ low back pain
- Psychosocial history
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Chief Complaint
(OPQRST system)
- Onset
- Palliating and provoking factors
- Quality
- Region or site of symptom
- Severity
- Timing of onset and duration of symptom
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Chief Complaint
(Additional Infomation)
- Statement of general health
- Course since onset
- Effects on activity
- Associated S/S
- What does the patient think is going on?
- Is anyone else having similar symptoms?
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Regions of the Abdominal Area
- Right hypochondriac region
- Epigastric region
- Left hypochondriac region
- Right lumbar region
- Umbilical region
- Left lumbar region
- Right iliac region
- Hypogastric region
- Left iliac region
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Steps of Assessment
Standards:
- Ensure that the patient has an empty bladder
- Perform auscultation before palpation or percussion
- Locate findings according to the abdominal quadrants
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Equipment for assessment
- Stethoscope
- Adequate lighting
- Warm hands w/ short fingers
- Small pillow
- Tape measure
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Abdominal Assessment
Patient Preparation
- Room should be warm and patient's upper chest/legs should be draped
- Expose the abdomen just above the xiphoid process down to the symphysis pubis
- Patient should be supine with arms down to the sides and knees slightly bent
- Use a small pillow for relaxation of abdominal muscles
- Keep hands and stethoscope warm
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Abdomina Assessment
Inspection
- Color
- Contour
- Symmetry
- Umbilicus
- Pulsations
- Peristalsis
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7 F's of abdominal distention
- Fat
- Flatus
- Fetus
- Feces
- Fluid
- Fibroid
- Fatal growth
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Contour of the Abdomen
- Flat
- Rounded (Convex)
- Scaphoid (Concave)
- Protuberant
- Obese
- Pendulous
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Abdominal Assessment
Auscultation
- Bowel sounds are high pitched, gurgling, cascading sounds occuring every 5 to 20 seconds
- Use the diaphragm of the stethoscope
- Assess all quadrants in a clockwise manner
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Abdominal Assessment
Abnormal Bowel Sounds
- Increased bowel sounds - diarrhea or early bowel obstruction
- Decreased bowel sounds - abdominal surgery or late bowel obstruction (may need to re-awake the bowels)
- Absent bowel sounds - peritonitis or paralytic ileus
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Abdominal Assessment
Vascular sounds (Bruits)
- Assess over the aorta, renal arteries, iliac and femoral arteries
- Use the bell of the stethoscope
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