GI Assessment

• A gastrointestinal tract assessment include inspection, auscultation, and light palpation of the abdomen to identify visible abnormalities; bowel sounds and softness/tenderness. Ensure stomach is not full at time of assessment as this may induce vomiting.
• What is the purpose of the digestive system?


  Digestion of food to meet the body's nutritional needs and elimination of waste resulting from digestion.
• Saliva produced by salivary glands contains enzymes such as amylase which begins chemical digestion of carbohydrates into sugars.
• Oesophagus


  Carries food down from the mouth to the stomach
• What is the function of the stomach?


  Secretes gastric juice and hydrochloric acid, and activates enzymes, continues to breakdown food and kill off any pathogens. Stores and churns food. Enzyme pepsin digests proteins.
• What is the function of the pancreas?

  A gland that make enzymes for digestion, and bicarbonate to neutralise stomach acid. Also makes the hormone insulin, which helps the body turn food into energy, and regulate blood sugar levels.
• Function of large intestine (Colon)?

  Absorbs water and electrolytes from stool. Also contains beneficial bacteria which help produce certain vitamins. Forms and stores faeces.
• Appendix


  A pouch attached to the first part of the large intestine.
• Function of Small intestine

  Digests proteins, fats and carbs. Bacterial metabolism plus nutrients and excess water absorption. Surface is covered in villi for greater absorption.
• Function of Gallbladder


  Stores the bile made in the liver, then empties it into the small intestine to help digest fats. Stones can form within.
• Functions of Liver


  Largest organ inside body. Makes bile. Changes food into energy; and clears alcohol, some medicines and poisons from the blood. Stores vitamins and iron. Destroys old blood cells.
• Bile


  Fluid that helps break down fats and gets ride of wastes in the body
• Function of Pharynx 


  Directs food into the stomach to prevent choking
• Function of Mouth 


  Salivary enzymes begin carb digestion and break up food particles.
• Function of the Rectum 


  Lower end of the large intestine, leading to the anus. Stores and expels faeces.
• What organs are part of the Upper GI Tract?


  Mouth, Oesophagus and Stomach
• The mouth includes the teeth, salivary gland (Below tongue and behind nose) and the tongue.
• What organs are part of the lower GI tract?


  Small intestine, large intestine, rectum and anus
• What are the accessory organs of the digestive system?


  Liver, Gallbladder and Pancreas
• The Abdominal wall muscles consisted of the External abdominal oblique, internal abdominal oblique and the Transverse abdominus.
• The function of abdominal wall muscles is to protect the internal organs and allowing normal functional compression activities. e.g. coughing, sneezing, urination, defecation and childbirth.
• What happens to the abdominal muscles in pregnancy?

  During pregnancy the rectus abdominis separates. It impacts on the pregnant women's ability to set her core muscles.
• How to assess focused GI system?

  Inspect abdomen, Auscultate for presence of bowel sounds, Gently percuss over abdomen, Lightly palpate each quadrant, Assess for recent and frequency of bowel movement.
• Abdominal Quadrants

  
• Assessment: Inspection


  Contour, Symmetry, Skin (Colour, moisture, scaring), Pulsation or movement and Umbilicus (Midline, inverted, everted, swelling).
• Types of Abdomen: Inspection

  
• Assessment: Auscultation


  Listen for 1-3 min in all quadrants (systematically and compare), Before percussion and palpation. Normal: low pitched continuous gurgles.
• Different Bowel sounds

  
• Assessment: Percussion


  To determine the size of solid organs, and presence of masses, fluid and gas (all 4 quadrants).
• Assessment: Palpation


  Assessing the shape, size of organs. Tenderness or pain. Light or Deep palpation.
• Focused GI History : Subjective Data

  Change in appetite, Weight gain or loss, Presence of dysphagia, Intolerance to certain foods, Pain, Nausea / vomiting, Change in bowel habits.
• Nutritional assessment

  -       Difficulty chewing

  -       Pain in relation to eating and digestion.

  -       BMI , height, weight
• Nutritional Risk : Overnutrition


  The intake of nutrients is oversupplied and the amount of nutrients exceeds the amount required for normal growth, development and metabolism.
• Health Waist Measurement for women is 80-88cm, men is 94-102cm
• Body Mass Index (BMI)

  
• Dehydration in Adults: Hypotension, Mental Disorientation, Weight Loss, Fever, Cracked lips, Tachycardia etc.
• Dehydration in Infants: Sunken anterior fontanelle (top of head), Circulation changes, Loss of elasticity, Prolong capillary refill etc.
• Overhydrated: Drinking and retaining too much fluid, Bounding pulse, Pale Urine, Neurological changes and Respiratory etc.
• Faecal Elimination: Normal faeces, Constipation and Diarrhoea. Assessment = Changes from normal routine, size consistency and colour should be noted.
• What does normal faeces look like?

  Soft formed stools, Influenced by diets. Newborn: Meconium (black tarry). Adult: Brown to green colour.