Nursing Care for Adults

This document provides information on nursing care and assessment for adults with chronic conditions. It discusses various tests and procedures used in the diagnosis and treatment of GI tract issues. It also explores the role of nurses during nursing interventions and lists common drugs prescribed in GI procedure rooms.

Running Head: NURSING CARE FOR ADULTS 1
Nursing Care for Adults
Student’s Name
Institution Affiliation

Nursing Care for Adults 2
Nursing Care for Adults
Section 1
According to Lewis et al. (2014), nursing care and assessment is essential in adults who
may develop various chronic conditions. As such, various tests are essential in determining
which area may be affected by the different infection. Contrary, the main function of the GI tract
is to break down food into nutrients, so that they may be absorbed into the body to provide
energy. It should be noted that food must first be ingested through the mouth for the mechanical
process to begin.
Oral Cavity
This is also known as the mouth, which is responsible for food intake A mucosa lines it with
keratin covering different parts, for example, hard palate, tongue, and the mouth’s roof. In spite
of that, the mastication refers to food that gets broken down mechanically by chipping and
chewing using the teeth. It is vital to note that the tongue acts as a muscular organ, which
manipulates food bolus to meet with the teeth.
1. Esophagus
This is located in the throat near the trachea (windpipe). The food ingested is received by the
esophagus from the mouth after swallowing. This is made possible by numerous muscular
contractions (peristalsis). The throat acts as a delivery route for food into the stomach.
2. Abdominal Wall
The abdominal wall acts as the casing for the abdominal cavity, which protects and contains the
GI organs. Alternatively, it supports the trunk and facilitates movement. It should be noted that

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there are several abdominal muscles such as the internal obliques, rectus abdominis, external
obliques, and transverses abdominis. It is also crucial to note that the muscles are layered on top
of each other, which enables them to control the movement of the rib cage, pelvis, and spine.
Listing the Parts of the Stomach
Small Intestine
This is composed of the jejunum. Ileum, and duodenum. The small intestine is approximately six
meters long, and it extends from the Stomach’s pyloric sphincter to the ileo-caecal valve-this
separates the caecum from the ileum.
Large Intestine
This is a horse-shoe shaped intestine that extends around the small intestine acting like a frame.
Moreover, it contains different sections: caecum, appendix, colon, and rectum. Also, there are
four parts of the colon: transverse, ascending, sigmoid, and descending.
Liver
This is a large red-brown organ that is located in the right upper abdominal quadrant. The liver
filters the blood traveling from the intestinal system. As such, it detoxifies various metabolites
such as broken down metabolites of the oestrogen and bilirubin.
Gall Bladder
This is a pear-shaped hollow organ, which is located in a depression on the surface posterior of
the right lobe of the liver. It consists of a neck, body, and fundus. The primary function is to
store bile concentration.
Pancreas

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This is a pink-grey lobular organ, which is behind the stomach, and it assists in communication
with the duodenum. The pancreas acts both endocrine and exocrine functions.
Rectum
This is a chamber that is approximately eight inches that links the anus to the colon. The primary
function of the rectum is to act as a stool storage area received from the colon.
Anus
This is the last section of the digestive tract, which is a canal consisting of two anal sphincters
and pelvic floor muscles.
Section 2
Abdominal X-Ray or KUB
KUB X-ray is performed to help diagnose the causes of abdominal pain, for instance,
perforations, obstructions, and masses. This contains necessary information about the shape,
position, and size of the kidney, bladder, and ureters. On the other hand, Abdominal X-ray
involves a small dose of radiation ionization, which produces an image of the abdominal cavity.
During preparation, the doctor may use IUD for the Abdominal X-ray. During preparation of the
KUB X-ray, the doctor may ask the patient to remain in a specific position depending on the
organ being viewed. Also, a lead apron may be put on parts of the body that are not going to be
X-rayed.
Abdominal Ultrasound
This views structures inside the abdomen. During preparation, the patients need to avoid drinks
and food for at least eight hours.

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Abdominal CT Scan
This is an imaging procedure which utilizes X-rays and CT to produce axial or horizontal images
of the body. During preparation, a contrast dye may be used to monitor the period any side
effects may cause. On the other hand, the doctor may conduct a CT scan without contrast; then
the patient can drink or eat and take the prescribed medication before the examination.
Upper GI Series
This X-ray shows images of the stomach, esophagus, and small intestines. Also, the barium
offers a picture of the upper GI structure using the X-ray. During preparation, the tests do not
require anesthesia, and instructions may be provided regarding a restricted diet for a couple of
days before the procedure.
Lower GI Series
This is an X-ray procedure used to view the large intestine. During preparation, the doctor may
change the diet of the patient, and clean out his or her bowel.
The endoscopic US
This is an invasive procedure used to evaluate GI and lung diseases. During preparation, the
patient should not drink or eat anything for at least six hours. This may be followed up by
prescribed medication by the doctors who is to conduct the procedure.
HIDA Scan
This X-ray procedure provides images that evaluate biliary system patency, and hepatocellular
function through tracing the flow and production of bile from the liver throughout the biliary
system into the small intestines (Kaoutzanis et al., 2015). During preparation, the patient must

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not eat or drink anything for at least four hours before the administration of a
radiopharmaceutical.
Colonoscopy
A CT colonography can be used to evaluate the rectum and colon, and detecting abnormalities,
for instance, cancer and polyps.
Virtual Colonoscopy
This is a diagnostic approach that enables the generation of two and three-dimensional images of
the rectum and colon. Additionally, a CT colonoscopy, CT pneumocolon, and CT colonography
may be used during the procedure. During preparation, the patient may be required not to drink
or eat anything for at least four hours, and patients cannot be sedated because of the medical
conditions.
Direct Colonoscopy
This requires IV sedation which is often performed on outpatients. The procedure also enables
the identification of precancerous polyps, and do a biopsy.
EGD
This is a procedure that utilizes a fiber-optic tube with a camera and light to evaluate the mucosal
surface of the upper GI tract. During preparation, sedation may not be necessary, and the patient
should not drink or eat for at least five hours. This would enable proper visualization of the entire
stomach, esophagus, and the second section of the jejunum and duodenum.
ERCP

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This procedure combines the upper GI endoscopy, and X-rays to treat issues in the pancreatic
and bile duct. During the preparation, the patient may be advised not to eat or drink anything.
Capsule Endoscopy
This X-ray is used to view the small intestine, and during the preparation, the doctor may
recommend an overnight fast and clean liquid diet.
Sigmoidoscopy
This may involve a screening procedure using a flexible tube with a proper camera, which is
inserted into the anus to examine the lower colon and rectum for cancer or causes of pain and
bleeding. Preparation is conducted 24 hours prior to the procedure, and the patient is advised to
take the liquid diet (Romero & Mahadeva, 2013).
PTC
This procedure involves a PTC type BaTiO three ceramics that is lowered to room temperature;
this is produced using a fundamental multilayer process. During the preparation of the procedure,
the patient is advised to take a light diet within 24 hours prior to the procedure.
MRCP
This is procedure utilizes magnetic fields, computer, and radio waves to examine the gallbladder,
liver, pancreatic duct and bile duct for infection. During preparation of the procedure, guidelines
on a diet may be stipulated prior to an MRI exam. Furthermore one should not eat anything for at
least five hours before the procedure.
Liver Biopsy

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This is conducted to examine the patient of any liver diseases especially chronic infections (Lee
et al., 2015). The process involves a needle used to remove a sample between one to three
centimeter, and between 1.2 to 2 mm wide. During preparation, the physician may contact blood
tests that will ensure the patient’s blood clots properly. Additionally, the procedure should be
conduct at least eight hours after a patient does not consume any food or drink; this reduces any
risk of aspiration.
Lab Studies
Amylase
This is a protein that is made by pancreas and glands around and in the throat and mouth. This
helps humans to break down starches and carbohydrates into sugar (Thoma, Kirschbaum, Wolf
& Rohleder, 2012). As such, the test for proteins in the mouth and throat is called the amylase
test.
Lipase
This is a test that measures the protein level in human called lipase, which helps in absorbing fats
released by the pancreas, and glands between the spine and stomach.
Gastrin
This is a hormone which stimulates gastric acid secretion by the stomach, and helps in gastric
motility (Yakut et al., 2013). As such, it is secreted by G cells in the stomach’s pyloric antrum,
pancreas, and duodenum.
Liver Function

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The liver function tests measure particular enzymes, substances, and proteins. Albumin is a
protein produced by the liver, while the enzymes that are found in the liver include ALT, AST,
ALP, and GGT (Vella et al., 2012). In spite of that, the bilirubin is a yellow substance that forms
part of the bile. Thus, it is formed when RBCs are broken down. This means that too much
bilirubin may cause jaundice in the blood.
OB Stool
This is a stool test that is conducted as part of every physical examination routine to detect occult
blood present in the GI tract. The OB presence in the stool may show malignant and benign GI
tumors, hematobilia, and ulcers.
The Role and Planning of Nurses During Nursing Interventions
The primary role of a registered nurse is to provide care for patients with regards to their
respective religious backgrounds and support them through the healing process. Thus, the nurse
may need to assist the patient in managing their medical situation by providing appropriate
treatment decisions (Perry, Potter & Ostendorf, 2013). This is made possible through assessing
the signs that may identify a particular disease, and provide proper recommendations. In spite of
that, the nurse is responsible for educating the patient regarding their medical condition, and the
best treatment that is available for the patient.
Regular Drugs Prescribed in GI Procedure Rooms
For Sedation
Fentanyl
This is drug prescribed to people living with cancer, and those ailing from chronic diseases.

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Versed
This is a drug often utilized for anesthesia and procedural sedation for children.
Demerol
This is an opioid that is prescribed for treating moderate to severe pain.
For Decreased Heart Rate
Atropine
This medication is used to manage specific types of pesticide poisoning and nerve agent. Also,
the drug leads to specific slow heart rate and minimizing the production of saliva during the
surgery.
For Colon Spasms
Levsin
This drug is used to treat various intestinal and stomach problems, for example, irritable bowel
disorder and cramps.
Reversal Agent Medication
Narcan
This is a nasal spray used for emergency treatment of suspected or known opioid overdose.
Romazicon
This medication is prescribed to manage certain benzodiazepines overdose. In spite of that, the
medication is used to manage medical procedures where benzodiazepines are used.

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References
Kaoutzanis, C., Davies, E., Leichtle, S. W., Welch, K. B., Winter, S., Lampman, R. M., &
Arneson, W. (2015). Is hepato-imino diacetic acid scan a better imaging modality than
abdominal ultrasound for diagnosing acute cholecystitis?. The American Journal of
Surgery, 210(3), 473-482.
Lee, Y. N., Moon, J. H., Kim, H. K., Choi, H. J., Choi, M. H., Kim, D. C., & Kim, Y. S. (2015).
Usefulness of endoscopic ultrasound‐guided sampling using core biopsy needle as a
percutaneous biopsy rescue for diagnosis of solid liver mass: Combined histological‐
cytological analysis. Journal of gastroenterology and hepatology, 30(7), 1161-1166.
Lewis, S. L., Bucher, L., Heitkemper, M. M., Harding, M. M., Kwong, J., & Roberts, D.
(2014). Medical-surgical nursing: assessment and management of clinical problems,
single volume. Elsevier Health Sciences.
Perry, A. G., Potter, P. A., & Ostendorf, W. (2013). Clinical nursing skills and techniques.
Elsevier Health Sciences.
Romero, R. V., & Mahadeva, S. (2013). Factors influencing quality of bowel preparation for
colonoscopy. World journal of gastrointestinal endoscopy, 5(2), 39.
Thoma, M. V., Kirschbaum, C., Wolf, J. M., & Rohleder, N. (2012). Acute stress responses in
salivary alpha-amylase predict increases of plasma norepinephrine. Biological
psychology, 91(3), 342-348.
Vella, S. J., Beattie, P., Cademartiri, R., Laromaine, A., Martinez, A. W., Phillips, S. T., &
Whitesides, G. M. (2012). Measuring markers of liver function using a micropatterned

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paper device designed for blood from a fingerstick. Analytical chemistry, 84(6), 2883-
2891.
Yakut, M., Örmeci, N., Erdal, H., Keskin, O., Karayel, Z., Tutkak, H., & Soykan, I. (2013). The
association between precancerous gastric lesions and serum pepsinogens, serum gastrin,
vascular endothelial growth factor, serum interleukin-1 Beta, serum toll-like receptor-4
levels and Helicobacter pylori Cag A status. Clinics and research in hepatology and
gastroenterology, 37(3), 302-311.