Gastrointestinal System

gastrointestinal-system

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516368

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A client has been diagnosed with an incompetent pyloric sphincter. This client is experiencing a lot of abdominal pain and nausea. When this client vomits, the nurse should expect what type of secretions will be in the basin?

Select the correct answer(s).

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Explanation

The pylorus is located between the body of the stomach and the duodenum. At the end of the pyloric canal, the circular smooth muscle layer thickens to form the pyloric sphincter. This muscle serves as a valve that controls the rate of stomach emptying and prevents the regurgitation of intestinal contents back into the stomach. Therefore, if the pyloric sphincter is incompetent, intestinal content will flow back into the stomach.

516369

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A client who has had his gallbladder (GB) removed asks the nurse, “Why do I feel sick every time I go through a drive-in fast-food restaurant and order burgers and fries?” The nurse bases the response knowing that:

Select the correct answer(s).

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Explanation

The common bile duct and pancreatic duct empty their juices into the duodenum. Bile, a fluid synthesized by the liver that breaks down lipids, and pancreatic juices, which facilitate digestion of lipids, carbohydrates, and proteins, enter the intestine through these ducts. If the GB is removed, a high-lipid meal may not be broken down and digested normally. Neither the stomach size nor the pancreatic duct is removed during GB surgery.

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A client asks the nurse to explain the digestive tract layers because the client is experiencing upper GI problems. When talking about the mucosa layer, the nurse will emphasize that the roles/functions of this layer consist of: Select all that apply.

Select the correct answer(s).

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Explanation

The inner layer is the mucosal layer that produces mucus. This mucus protects and lubricates the inner lining of the GI tract lumen. Secretion of digestive enzymes and substances that break food down, absorption of the breakdown products of digestion, and maintenance of a barrier to prevent the entry of noxious substances and pathogenic organisms also occur in the mucosal layer. Contracting of smooth muscles to propel food forward occurs in the muscularis externa layer. Supporting the abdominal viscera with its connective tissue is the role of the serous layer.

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A client has been told he has abdominal adhesions due to an old appendix infection. Knowing the structures of the abdominal cavity, the nurse will explain which of the following structures can form bands of fibrous scar tissue to wall off the infection, preventing it from spreading to other parts of the body?

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Explanation

The greater omentum helps to prevent infection from entering the peritoneal cavity and protects the intestines from cold. It often forms adhesions (i.e., bands of fibrous scar tissue) adjacent to inflamed organs such as the appendix, walling off the infection and thereby preventing its spread. The peritoneum is the largest serous membrane and constitutes the outer wall of the intestine, continuous with the mesentery. Haustration is the segmental mixing movements of the large intestine (colon).

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Motility along the length of the GI tract, controlling the function of each segment of the GI tract and integrating signals for absorption of nutrients primarily, is innervated by which portion of the enteric nervous system?

Select the correct answer(s).

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Explanation

The enteric nervous system consists of the intramural neurons (contained in the gastrointestinal tract) of two networks—myenteric and submucosal plexus. The submucosal plexus, which lies between the submucosal and mucosal layers of the wall, is mainly concerned with controlling the function of each segment of the GI tract. It integrates signals received from the mucosal layer into control of motility, intestinal secretions, and absorption of nutrients. The ANS innervates the preganglionic parasympathetic fibers and controls vasovagal reflexes. Sympathetic innervation is mediated by intramural plexus activity.

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When trying to explain to a newly diagnosed irritable bowel syndrome (IBS) client how the nervous system affects gastrointestinal (GI) disorders, the nurse mentions which of the following in regard to IBS?

Select the correct answer(s).

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Explanation

Stimulation of the parasympathetic nervous system causes a general increase in activity of the entire enteric nervous system. Sympathetic stimulation inhibits activity, causing many effects opposite to those of the parasympathetic system, including enhancement of sphincter function, decreased motility, and increased smooth muscle tone.

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The client chews an apple and starts the swallowing process. As the food bolus enters the back of the mouth and swallowing is initiated, the nurse knows that the client's motor impulses are being carried out by which of the following cranial nerves? Select all that apply.

Select the correct answer(s).

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Explanation

The esophageal phase is innervated by the vagus (X) nerve, which initiates the peristaltic waves that will carry the food bolus into the stomach. Gagging is a protective reflex response that can occur during the pharyngeal phase, to prevent food from entering the larynx. Tactile receptors initiate the involuntary part of swallowing during the pharyngeal stage. Hypoglossal (XII) and trigeminal (V) nerves are part of the oral and pharyngeal phases of swallowing. Abducent (VI) is a motor nerve that supplies to the pons and perform function of turning eye laterally.

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In the stomach, chyme is churned by peristalsis into the antrum, which contracts, reverses the flow, and allows more churning. Because the pylorus is contracted during antral contraction, gastric content empties into the duodenum:

Select the correct answer(s).

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Explanation

Gastric contents can empty into the duodenum between antral contractions that block the pylorus. The pH, fatty acid content, and osmolarity of the chyme stimulate cholecystokinin and gastric emptying. Constriction of the pyloric sphincter prevents the backflow of gastric contents and allows them to flow into the duodenum at a rate commensurate with the ability of the duodenum to accept them.

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While assessing a client who is experiencing diarrhea caused by Clostridium difficile, the nurse should anticipate hearing:

Select the correct answer(s).

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Explanation

Inflammatory changes increase motility, which would lead to hyperactive bowel sounds. In many instances, it is not certain whether changes in motility occur because of inflammation or are secondary to the effects of toxins or unabsorbed materials.

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A client who is quadriplegic following a motor vehicle accident adheres to a bowel protocol to promote regular bowel movements and prevent constipation. Which of the following actions performed by the client's caregiver is likely to promote defecation?

Select the correct answer(s).

(0/0)

Explanation

When the nerve endings in the rectum are stimulated, signals are transmitted first to the sacral cord and then reflexively back to the descending colon, sigmoid colon, rectum, and anus by the pelvic nerves. These impulses greatly increase peristaltic movements as well as relax the internal sphincter, resulting in defecation. Massage, increased fluid intake, and upright positioning are less likely to promote defecation.

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While planning care for a client with irritable bowel syndrome, knowing the client has an increased amount of secretions with impaired GI absorption, the priority nursing diagnosis would be:

Select the correct answer(s).

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Explanation

Intestinal secretions are mainly water (it contains electrolytes, but the main component is water). Altered secretion or absorption causes fluid volume deficit (dehydration—not hypervolemia), which correlates with hypertonicity (not hypotonicity). Fatigue may be related to loss of volume, but the priority is to restore fluid volume. With lots of secretion loss, the client will likely experience metabolic alkalosis (not acidosis).

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When discussing digestion with a group of nursing students, the instructor asks, “Where does the digestion of our food begin?” The most accurate student response would be:

Select the correct answer(s).

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Explanation

Saliva performs three roles: lubrication, antimicrobial protection, and initiation of starch digestion. Saliva contains ptyalin and amylase, which initiate the digestion of dietary starches. The other portions of the GI tract aid in digestion, but all begins in the mouth.

516380

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Biopsy results reveal that a client has a deficit amount of parietal (oxyntic) cells in their stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:

Select the correct answer(s).

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Explanation

The oxyntic glands are located on the inside surfaces of the body and fundus of the stomach. They secrete HCl and intrinsic factor, which is needed for vitamin B12 absorption.

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Which of the following clients likely faces the greatest risk of a gastrointestinal bleed?

Select the correct answer(s).

(0/0)

Explanation

The gastric mucosa can be easily damaged by drugs such as aspirin, resulting in local ischemia, vascular stasis, hypoxia, and tissue necrosis. Antihypertensives, diuretics, antibiotics, and benzodiazepines do not pose such a significant threat to the integrity of the gastric mucosa.

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In addition to mucus, the intestinal mucosa produces two other types of secretions. Copious amounts of the serous-type fluid are secreted to act as a:

Select the correct answer(s).

(0/0)

Explanation

An isotonic alkaline fluid is secreted by crypts of Lieberkühn in the intestinal mucosal layer at a high rate, to secrete mucus, electrolytes, and water and to act as a vehicle to aid absorption. Surface enzymes split sugars. Parasympathetic stimulation increases secretion of mucus. Brunner glands secrete large amounts of alkaline mucus to protect the duodenum from acid content.

Gastrointestinal System

Question 1 of 1

Time Left

A client has been diagnosed with an incompetent pyloric sphincter. This client is experiencing a lot of abdominal pain and nausea. When this client vomits, the nurse should expect what type of secretions will be in the basin?

Select the correct answer(s).

(0/0)

Explanation

A client who has had his gallbladder (GB) removed asks the nurse, “Why do I feel sick every time I go through a drive-in fast-food restaurant and order burgers and fries?” The nurse bases the response knowing that:

Select the correct answer(s).

(0/0)

Explanation

A client asks the nurse to explain the digestive tract layers because the client is experiencing upper GI problems. When talking about the mucosa layer, the nurse will emphasize that the roles/functions of this layer consist of: Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

Select the correct answer(s).

(0/0)

Explanation

Motility along the length of the GI tract, controlling the function of each segment of the GI tract and integrating signals for absorption of nutrients primarily, is innervated by which portion of the enteric nervous system?

Select the correct answer(s).

(0/0)

Explanation

When trying to explain to a newly diagnosed irritable bowel syndrome (IBS) client how the nervous system affects gastrointestinal (GI) disorders, the nurse mentions which of the following in regard to IBS?

Select the correct answer(s).

(0/0)

Explanation

The client chews an apple and starts the swallowing process. As the food bolus enters the back of the mouth and swallowing is initiated, the nurse knows that the client's motor impulses are being carried out by which of the following cranial nerves? Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

In the stomach, chyme is churned by peristalsis into the antrum, which contracts, reverses the flow, and allows more churning. Because the pylorus is contracted during antral contraction, gastric content empties into the duodenum:

Select the correct answer(s).

(0/0)

Explanation

While assessing a client who is experiencing diarrhea caused by Clostridium difficile, the nurse should anticipate hearing:

Select the correct answer(s).

(0/0)

Explanation

A client who is quadriplegic following a motor vehicle accident adheres to a bowel protocol to promote regular bowel movements and prevent constipation. Which of the following actions performed by the client's caregiver is likely to promote defecation?

Select the correct answer(s).

(0/0)

Explanation

While planning care for a client with irritable bowel syndrome, knowing the client has an increased amount of secretions with impaired GI absorption, the priority nursing diagnosis would be:

Select the correct answer(s).

(0/0)

Explanation

When discussing digestion with a group of nursing students, the instructor asks, “Where does the digestion of our food begin?” The most accurate student response would be:

Select the correct answer(s).

(0/0)

Explanation

Biopsy results reveal that a client has a deficit amount of parietal (oxyntic) cells in their stomach. The client asks the nurse to explain what this means. The nurse explains that parietal cells secrete HCl and intrinsic factor, which is needed for absorption of:

Select the correct answer(s).

(0/0)

Explanation

Which of the following clients likely faces the greatest risk of a gastrointestinal bleed?

Select the correct answer(s).

(0/0)

Explanation

In addition to mucus, the intestinal mucosa produces two other types of secretions. Copious amounts of the serous-type fluid are secreted to act as a:

Select the correct answer(s).

(0/0)

Explanation

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