Assessment of Digestive and
GI Function
Connie K. Cupples, MS, MSN, RN
Union University
Outcome 1
• Review the structure and function of the
organs of the GI tract.
• A. Draw abdomen depicting organs in the
four quadrants.
• B. Identify function of each of the organs
of digestion.
Abdomen
Function of Organs
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Mouth
Stomach
Small Intestine
Colon
Outcome 2
• Explain the processes involved in the
digestion, absorption, and elimination of
food products.
A. Identify major digestive enzymes,
sources, and digestive actions.
refer to pg. 943 table 34-1
Action of enzymes that digest CHO,
protein, and fat
Outcome 3
• Describe assessment paramaters and
techniques used when evaluating the GI
tract.
• A. Draw a torso and shade common sites
of referred abdominal pain.
• B. Discuss the order of the examination of
the abdomen and give the rationale.
Sites of Referred Abdominal Pain
Health History
• Focus on symptoms common to GI
dysfunction:
Pain
Indigestion
Intestinal gas
Change in bowel habits
Change in stool characteristics
Physical Assessment
• Inspect mouth and contents
• Supine with knees flexed slightly
• Order of assessment:
inspection
auscultation
palpation
percussion
Rationale for order of GI Assessment?
Abdomen - Ascites
Abdomen-Obese
Abdomen - Hernia
Outcome 4
• Describe preparation, education, and
follow-up care for patients undergoing the
following diagnostic testing of the GI tract.
• A. Discuss how the nurse would prepare
and educate patients for GI tests, including
post procedure interventions.
Stool Tests
• Collect on random basis except specimen
where quantitative study is performed
(fecal fat and urobilinogen)
• Refrigerate quantitative specimen (24-72
hr. collections)
• Special diet required for some tests
• Fecal occult blood tests (foods & meds
may alter results.
Abdominal Ultrasonography
• Noninvasive means of imaging abdominal
organs and structures.
• NPO for 8-12 hrs.
• Fat-free meal at supper if GB studies are
done
• Schedule barium studies after test if
ordered as well
Upper GI X-ray Studies
X-ray imaging after contrast media injested.
Low residue diet X several days prior
NPO after MN
Laxative prep
Discourage smoking day of test
Hold all meds on day of test
Monitor post test for 3 days to get rid of
barium (fluids, laxatives, enemas)
Lower GI X-ray Studies
• Visualization of lower GI tract after
instillation of barium
• Bowel prep to cleanse lower bowel
• Low-residue diet 1-2 days prior
• C/L diet for supper, laxative HS, NPO after
MN
• Cleansing enemas until clear in a.m.
• Post procedure elimination of barium
CT
• Cross-sectional images of abdominal
organs and structures
• NPO 6-8 hrs. before test
• Question about contrast dye allergies
• Schedule barium studies after CT scan if
ordered
MRI
• Noninvasive technique to supplement
ultrasonography and CT scanning
• NPO 6-8 hrs. prior to test
• Remove all jewelry & other metals
• Explain that procedure lasts 30-90 minutes
• Explain type of equipment used (pt. may
experience claustrophobia & hear
knocking sound)
Esophagogastroduodenoscopy
• Visualization of upper GI tract with
fiberoptic lenses.
• NPO 6-12 hrs.
• Pt. may gargle with local anesthetic
• Versed given IV – monitor pt. per
conscious sedation protocol
• Atropine may be given to dry secretions
• Position on left side during procedure
Nursing Interventions Post EGD
• Keep NPO until return of gag reflex
• Simms position until awake, then semifowlers
• Observe for s/s of perforation (pain,
bleeding, unusual difficulty swallowing,
temp)
• Monitor for changes in P & BP
• Instruct not to drive for 10-12 hrs. post
EGD
Colonsocopy
• Direct visual inspection of the colon using
flexible fiberoptic colonoscope.
• Colon preparation a must
• C/L diet at noon day before
• Laxatives the night before
• Use of preparation such as Golytely to
lavage the bowel over 3-4 hrs. until returns
are clear
Nursing Interventions post
Colonoscopy
• Monitor according to conscious sedation
guidelines
• Observe for s/s of bowel perforation
(abdominal pain, distention, rectal
bleeding, temp)
• Provide written instructions due to
amnesic effect of meds
Colonoscopy
Gastic Analysis, Gastic Acid
Stimulation test & pH Monitoring
• Determines secretory activity of gastic
mucosa and gastric retention.
• NPO 8-12 hrs.
• Hold meds that affect gastic secretion
• Smoking not allowed day of test
• Insert small NG tube
• Aspirate entire contents of stomach q 15
minutes for 1 hr.
Gastic Acid Stimulation
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•
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Med given to stimulate gastric secretion
Inform pt. that flushing may occur
Monitor P & BP q 15 min.
Collect gastic specimen q 15 minutes for 1
hr.
pH Monitoring
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NPO 6 hrs. before test
Hold meds 24-36 hrs.
Probe inserted through nose
Connected to external recording device