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Potter and Perry 7th Edition Chapter 46

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Question
Answer
Purpose of the GI organs?   Absorb fluid and nutrients, prepare food for absorption and use by cells, and provide temp storage.  
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Where does mastication take place?   Mouth.  
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Where is the cardiac sphincter and what is its function?   Between the esophagus and the stomach, prevents reflux of stomach contents into the esophagus.  
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Purpose of the stomach?   Store food, mix food w/ gastric juices, emptying contents slowly into duodenum.  
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2 enzymes in the stomach facilitate the digestion of protein.   Pepsin and HCl  
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What in stomach juice is necessary for the absorption of Vitamin B12?   Intrinsic factor  
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What protects the stomach from digestive juices?   Gastric mucus.  
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What moves chyme through the intestine?   Segmentation and peristalsis.  
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What is an average amount of chyme moving through the small intestine in a day?   7-10 L  
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By the time 7-10 L of chyme reaches the end of the small intestine how much has it been reduced to?   600-800mL  
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What are the three sections of the small intestine?   Duodenum, jejunum, ileum  
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What is 8-11 inches and continues to process chyme from the stomach.   Duodenum  
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What is 8 feet long and has the primary function of absorbing carbohydrates.   Jejunum  
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What is 12 feet long and specializes in the absorption of water, fats, and bile salts.   Ileum  
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Which 2 sections of the small intestine absorb most nutrients and electrolytes?   Duodenum and jejunum  
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Which section of the small intestine absorbs certain vitamins, iron, and bile salts?   Ileum  
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About how long is the large intestine?   1.5-1.6 m or 5-6 ft  
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What names of the three parts of the large intestine?   Cecum, colon, rectum  
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What is the valve between the small intestine to the large intestine?   Ileocecal valve  
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What are the four segments of the COLON?   Ascending, transverse, descending, sigmoid  
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What are the three functions of the colon?   Absorption, secretion, and elimination  
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What does the amount of time spent in the colon have to do with a stool's consistency?   The amount of water absorbed determines how fluid/firm. Fast peristalsis = watery stool. Slow = hard stool  
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What does the large intestine absorb?   Water, sodium, and chloride.  
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Name some electrolytes secreted in the colon.   Bicarbonate and potassium  
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Bicarbonate is secreted in exchange for absorbing what?   Chloride.  
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How much water and salt is absorbed?   1 gallon water, 1 ounce salt.  
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What type of peristalsis moves undigested food toward the rectum?   Mass peristalsis  
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About how many times a day do we have mass peristalsis and when is the strongest?   3-4 times a day, strongest about an hour after mealtime  
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What is the main stimulus for contraction?   Intestinal content.  
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What are distended veins in the rectum caused by straining during defecation?   Hemorrhoids  
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What is the voluntary contraction of abdominal muscles while maintaining forced expiration? against a closed airway in order to expel feces called?   Valsalva maneuver.  
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Which patients should avoid Valsalva maneuver?   Anyone w/ hypertension, abnormal cardiac rhythm or other cardiovascular diseases, glaucoma, increased intracranial pressure, or surgical wound.  
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Oozing diarrhea, anorexia, abdominal distention, cramping, and rectal pain are signs of what?   Fecal impaction.  
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Infants GI tract?   Smaller stomach capacity, less digestive enzymes secreted.  
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When does control of defectation take place?   2-3 yrs.  
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What is the nondigestable residue in the diet that provide bulk to feces?   Fiber.  
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Fiber helps by?   Flushing fats and waste products with more efficiency.  
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Gas producing foods speed peristalsis by?   Distending intestinal walls causing motility. Gives the sense of intestinal fullness.  
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Food intolerance such as lactose intolerance is not ______?   An allergy. Causes body distress.  
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What other factors increase GI motility?   Physical activity, emotional stress.  
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What factors decrease GI motility?   Depression, 3rd trimester of pregnancy, surgery that directly manipulates the bowel.  
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How does leaning forward promote defecation?   by raising intra-abdominal pressure  
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What is the aim of treatment for diarrhea?   Prevent dehydration and electrolyte balance.  
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What stool consistency would be formed by an ostomy of the sigmoid colon?   Normal stool consistency  
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What stool consistency would be formed by an ostomy of the ileum?   Watery stool.  
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What are loop colostomies and when are they performed?   Loop colostomies are emergency situations. They temporary stomas of the transverse colon that is looped over a bridge to prevent it from slipping back in.  
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What kind of colostomy is used as surgical treatment for colorectal cancer?   End colostomy.  
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When is a temporary end colostomy with a Hartmann’s pouch used?   Patients with diverticulitis.  
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What advantage to a colostomy of the sigmoid colon have?   Can train the bowel to empty at a certain time of day w/o always having a bag.  
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Portion of the ileum is used to create a new rectum and connected to the anus?   Ileoanal pouch anastomosis.  
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A pouch of ileum that the patient catheterizes and empties several times a day?   Kock continent ileostomy.  
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Elevated levels of amylase in feces indicate?   Pancreatic disorder.  
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Elevated levels of carcinoembryonic antigen in feces indicate?   Elevated in cancer of the GI tract or hepatobiliary organs.  
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Elevated levels of biliruben in feces?   Hepatobiliary disease.  
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White or clay feces lack of?   Bile.  
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Black or tarry stool?   Upper GI bleeding or Iron ingestion.  
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Red in the stool?   Lower GI bleeding, hemorrhoids, or foods such as beets.  
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Pale color with fat in it?   Malabsorption of fat.  
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What is FOBT and FIT and how often should people over 50 have it?   Fecal Occult Blood Test, Fecal Immunochemical test; Yearly  
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What are the tests people over 50 should have every 5 years?   Flexible Sigmoidoscopy (FSIG), double contrast barium edema.  
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What test should people over 50 have every 10 years?   Colonscopy.  
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Patients on what medication should be regularly screened with a FOBT?   Anticoagulant for intestinal bleeding.  
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The American Cancer Society recommends yearly what test every 5 years.   FOBT and flexible sigmoidoscopy.  
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Name 4 factors that affect the character of feces.   Mechanical breakdown of food, GI motility, selective absorption, secretion of substances in the large intestine  
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2 factors that make up stool consistency?   Fiber and fluid intake.  
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Greatest dangers from diarrhea?   Fluid and electrolyte imbalance.  
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2 dangers during digital removal of stool   Trauma to rectal mucosa and vagas nerve stimulation.  
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What is the best time to administer an enema?   Before a patient’s normal time to defecate or immediately after a meal.  
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What are some harmful effects related to overuse of laxatives?   Permanent bowel damage, osteomalacia, electrolyte imbalance  
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How are cathartics classified?   Way they promote defecation.  
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How do stimulant cathartics cause defecation?   Irritate mucosa, increase motility, inhibit reabsorption of water.  
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What is the time frame of action for a stimulant cathartic?   6-8 hours  
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What catharttics stimulate motility and lubrication by osmosis?   Saline or osmotic cathartics  
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What is the time frame of action for saline or osmotic cathartics?   1-3 hours  
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What cathartic soften and lower the surface tension of the stool by allowing water and fat to penetrate and block absorption of water into the intestines?   Emollient or wetting agents  
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What kind of laxatives are the least irritating and safest?   Bulk forming laxatives.  
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How do bulk forming laxatives work?   Fecal bulk stretches intestinal walls stimulating peristalsis.  
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Which patients could benefit from mineral oil laxatives?   Painful hemorrhoids.  
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What are the problems associated with regular use of mineral oil?   Interference with absorption of A, D, E, K  
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What is the only safe type of enema for infants and children due to potential fluid imbalance?   Normal saline.  
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Volume of a cleansing enema?   750-1000mL  
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What kind of enema is for patients who cannot tolerate large amounts of fluid?   Hypertonic fluid.  
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How many mL are included in a hypertonic solution enema?   120ml to 180ml.  
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Narcotic analgesics, opiates, and anticholinergics affect elimination?   Decrease peristalsis and cause constipation.  
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Antibiotics affect elimination?   Destroy normal intestinal flora and produce diarrhea.  
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How does general anesthesia affect elimination?   Slows or stops peristalsis.  
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How does pregnancy affect elimination?   Constipation due to extra pressure on the rectum.  
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What is the correct temperature for and enema and why?   105 to 110 degrees to relax muscles. Colder causes muscle spasm. Hotter injures mucosa.  
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How come people can have heart attacks from going to the rest room?   Raised intra-thoracic pressure during straining cuts of venous return to the heart. It returns forcefully causing tachycardia and ^BP followed by reflex bradycardia  
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Which side should a person be lying on for an enema and why?   the left side because that is where the sigmoid colon is located  
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What is the purpose of a rectal tube?   Promote passage of flatus decreasing abdominal pressure  
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What is the function of soap in a soapsuds enema?   to irritate the bowel resulting in peristalsis  
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How far in is an enema tube inserted?   3-4 inches  
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Excessive use of what weakens the natural response to defecation?   laxatives  
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Irritation in the colon results in increase ____ secretion?   Mucus.  
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What is a common bacterial cause of diarrhea?   Clostridium difficile (C. diff)  
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How can C. diff be contracted?   Overgrowth of normal flora or contact with the organism.  
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If diarrhea is caused by a virus, what is the main goal?   Rid the GI tract of the virus instead of slowing peristalsis.  
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Visible peristalsis indicates?   Obstruction.  
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What is the difference in percussion sounds of gas or a mass/tumor/fluid?   Gas is tympanic, a mass/tumor/fluid are dull.  
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What percentage of solid stool is bacteria from the colon?   25%  
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What is another word for microscopic?   Occult.  
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Stool removed from an ostomy is called?   Effluent.  
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Which ostomy is the ONLY one that can be irrigated?   Colostomy.  
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Why is liquid stool, such as that from an iliostomy, so damaging to skin tissue?   Highly acidic and contains digestive enzymes.  
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