GASTRO INTESTINAL SYSTEM HEALTH ASSESMENT.pptx

GASTRO INTESTINAL SYSTEM HEALTH ASSESMENT

1. GASTRO INTESTINAL SYSTEM HEALTH ASSESMENT Presented by: Mercy Kayange Tendai Ngwira Doreen Masulani Francis Sande

2. OUTLINE Introduction Health history Physical examination Diagnostic & laboratory tests Conclusion references

3. INTRODUCTION The gastrointestinal (GI) system plays a critical role in the overall health and well-being of an individual. It is responsible for the ingestion, digestion, absorption, and elimination of food and nutrients. A thorough health assessment of the GI system is essential in identifying abnormalities, diagnosing disorders, and planning appropriate interventions. This presentation aims to provide an overview of the key components and techniques involved in the assessment of the GI system

4. GASTROINTESTINAL SYSTEM EXAMINATION It consist of examination of the; i . Oral cavity ii. Abdomen iii.Rectum

5. Gastro intestinal system examination Surface markings : Liver: Upper boarders 5th ICS right on full expiration ,lower boarder at coastal margin on full inspiration Spleen: Behind left 9,10,11 ribs, posterior to MCL Kidneys: Upper pole lies deep on the 12 th rib posteriorly, 7cm from the midline , the right is 2 to 3 cm lower than the left

6. HEALTH HISTORY Presenting Complaint 1. What brings you in today ? 2. Can you describe your symptoms ? (e.g., abdominal pain, nausea, vomiting, changes in bowel habits) 3. When did the symptoms start ? 4. Have the symptoms changed over time ?  

7. History of Presenting Complaint 1. Where is the pain located ? 2. What does the pain feel like ? (sharp, dull, cramping) 3. Does the pain radiate anywhere ? 4. What makes the pain worse or better ? 5. Are there any associated symptoms ? (e.g., fever, weight loss, jaundice)

8. Past Medical History 1. Have you ever been diagnosed with a gastrointestinal condition ? (e.g., GERD, IBS, Crohn’s disease) 2. Have you had any gastrointestinal surgeries ? (e.g., appendectomy, cholecystectomy) 3. Do you have any chronic conditions that affect your GI system ? (e.g., diabetes, liver disease)

9. Medication History 1. Are you currently taking any medications ? (e.g., antacids, laxatives, antibiotics) 2. Have you taken any medications for your GI symptoms ? (e.g., proton pump inhibitors, anti-diarrheal medications) 3. Do you use any over-the-counter supplements or herbal remedies?

10. Family History 1. Do any family members have gastrointestinal conditions ? (e.g., colorectal cancer, inflammatory bowel disease) 2. Is there a family history of liver disease or gallbladder issues?

11. Social History 1.What is your diet like ? (e.g., high in fiber, low in fat) 2. Do you consume alcohol or use tobacco products?** 3. Do you engage in regular physical activity?** 4. Are there any recent changes in your lifestyle or stress levels ?

12. Review of Systems 1. Have you experienced any changes in appetite or weight ? 2. Do you have any difficulty swallowing or chewing ? 3. Have you noticed any blood in your stool or changes in bowel habits ? 4. Do you experience bloating or gas?

13. PHYSICAL EXAMINATION General examination Hands: i.clubbing -inflammatory bowel disease/Cirrhosis/coeliac disease ii. Koilonychia - spooning of the nails i.e chronic iron deficiency iii.Leukonychia - whitened nail bed i . e hypoalbuminea, liver function , enteropathy iii. Palmar erythema - reddining of palms i.e liver problems or pregnancy

14. Continued….. Axilla Lymphadenopathy - malignancy or infection Hair loss- malnourishment or iron defieciency Icterus Jaundice –noted in the sclera- haemolysis/ hepatitis/ cirrhosis,billary obstruction

15. Methods of examining the GIT Inspection Palpation Percussion Auscultation Rectal Examination

16. Oral examination Lips Colour Blue or pale Ulceration Syphilis or vit B Inflammation iron deficiency

17. GUMS Color : Blue line( l ead poisoning) Bleeding : Acute leukaemia Swollen; Scurvy and pregnancy

18. TEETH HUTCHISON TEETH i.e. congenital syphilis

19. Tongue Color - i.e blue(cyanosis),Red( nicotinic poisoning), Pale (anaemia), black Tremors- Nervousness, Parkinsonism(neural disorder ) Size of the tongue- Macroglossia(enlargement of the tongue) Surface of the tongue - Dry tongue( dehydration , Bald tongue( anaemia), furred tongue (smoking, mouth breathing) Ulceration( whooping cough , T.B)

20. ABDOMINAL EXAMINATION

21. On the abdomen inspection is done first then auscultation , percuss and lastly palpate to avoid destruction with bowel movement Inspection Visual observation of the abdomen in the course of physical examination; contours of the abdomen i.e flat, rounded, scaphoid, protuberant; movement of the abdomen ( abnormal can be appendicitis, peritonitis) ,bulging; left abdomen(spleen),Right abdomen(liver),lumber region (kidney);umbilicus i.e the shape and posion of umbilicus; scars and striae and others.

22. 2.Auscultation The healthcare provider will use a stethoscope to listen to the sounds produced by the GI tract. They will listen for bowel sounds, which are typically high-pitched and gurgling, and assess for any abnormal sounds that may indicate disease or dysfunction

23. 3. Percussion The healthcare provider will tap the abdomen with their fingers to produce sounds that can be heard with the ear. Percussion is used to assess the size and position of the organs, detect fluid and identify areas of tenderness or pain

24. 4. Palpation The healthcare provider will use their hands to feel the abdomen and detect any abnormalities. They may palpate for tenderness, masses, or organ enlargement. The provider may also palpate the lower abdomen to assess for any fluid accumulation or swelling

25. Scheme for palpation Left iliac fossa Left lumber area ( for kidney) Left hypocondrium (for sleep) Right lumber area( for light kidney) Right hypochondriac( for liver and bladder) Right iliac fossa and hypogastrium( For urinary bladder and uterus Umbilical area( for artic and mesenteric lymph nodes)

26. DIAGNOTIC & LABORATORY TESTS There are several diagnostic and laboratory tests that may be necessary for evaluating the health of the gastrointestinal (GI) tract. These tests can help healthcare providers diagnose and manage a variety of GI disorders, including infections, inflammation, and cancer(Katz et al.,2018).

27. CONTINUED…….. 1. Blood tests: Blood tests can be used to assess for signs of infection, inflammation, or anemia. They can also be used to evaluate for any nutritional deficiencies or electrolyte imbalances. 2. Stool tests: Stool tests can be used to diagnose and identify the cause of gastrointestinal infections. They can also be used to evaluate for any blood in the stool or to assess for the presence of parasites or other organisms

28. CONT’D… 3. Imaging studies: Imaging studies, such as X-rays, CT scans, or MRI scans, can be used to evaluate the structure and function of the GI tract. They can help healthcare providers identify any abnormalities, such as tumors or strictures, and assess for any complications, such as abscesses or fistulas.

29. 4. ENDOSCOPY: Endoscopy is a procedure in which a thin, flexible tube is inserted into the GI tract to visualize the inside of the organs. It can be used to diagnose and evaluate a variety of GI disorders, including inflammation, ulcers, and cancer.

30. 5 . Biopsy: A biopsy is a procedure in which a small sample of tissue is removed from the GI tract for examination under a microscope. It can be used to diagnose and evaluate a variety of GI disorders, including cancer and inflammatory diseases.

31. CONCLUSION The gastrointestinal (GI) tract is a complex system that plays a vital role in the body’s overall health and function. It is responsible for the digestion and absorption of nutrients, as well as the elimination of waste products. The GI tract is composed of several organs, including the mouth, esophagus, stomach, small intestine, large intestine, and rectum.

32. References Feldman, M., & Friedman, L. S. (2015). Sleisenger and Fordtran's gastrointestinal and liver disease. Philadelphia, PA: Saunders 4 th Ed.) Guyton, A. C., & Hall, J. E. (2016). Textbook of medical physiology. Philadelphia, PA: Saunders . Kozie,B.(2016).KOZIER & ERB’S Fundamentals of nursing; concepts , process ,and practice (10 th Ed).New Jersey; prentice Hall . Katz, P. O., Gerson, L. B., & Vela, M. F. (2018). Guidelines for the diagnosis and management of gastroesophageal reflux disease. American Journal of Gastroenterology, 113(7), 939-948. Leigner, M. H., & Fordtran, J. S. (2019). Sleisenger and Fordtran's gastrointestinal and liver disease. Philadelphia, PA: Saunders.