Chapter 38
Assessment of Digestive and
Gastrointestinal Function
Functions of the Digestive Tract
❖ Breakdown of food for digestion
❖ Absorption into the bloodstream of small
nutrient molecules produced by
digestion
❖ Elimination of undigested unabsorbed
foodstuffs and other waste products
Terms
Digestion: begins with the act of chewing, in
which food is broken down into small particles
that can be swallowed and mixed with digestive
enzymes
Absorption: Absorption is the major function of
the small intestine. Absorption begins in the
jejunum and is accomplished by active transport
and diffusion across the intestinal wall into the
circulation
Elimination: phase of the digestive process that
occurs after digestion and absorption when
waste
products are eliminated from the body
Major Enzymes and Secretions
Chewing and swallowing: saliva, salivary
amylase
Gastric function: hydrochloric acid, pepsin,
intrinsic factor
Small intestine: amylase, lipase, trypsin, bile
Chyme, emulsification, peristalsis
Question #1
Is the following statement true or false?
Lipase is an enzyme that aids in the
digestion of
protein.
False
Rationale: Lipase is an enzyme that aids in
the
digestion of fats. Trypsin is an enzyme that
aids in the
digestion of protein.
Assessment of the GI System #1
Health history:
o Information about abdominal pain, dyspepsia,
gas, nausea and vomiting, diarrhea,
constipation, fecal incontinence, jaundice, and
previous GI disease is obtained
Pain:
o Character, duration, pattern, frequency,
location, distribution of referred abdominal pain,
and time of the pain vary greatly depending on
the underlying cause
Dyspepsia
o Most common symptom of patients with GI
dysfunction
Intestinal gas
o Bloating, distention, or feeling “full of gas” with
excessive flatulence as a symptom of food
intolerance or gallbladder disease
Nausea and vomiting
o Nausea is a vague, uncomfortable sensation
of
sickness or “queasiness” that may or may not be
followed by vomiting
Change in bowel habits and stool
characteristics
o May signal colonic dysfunction or disease
o Constipation, diarrhea
Past health, family and social history
o Oral care and dental visits
o Lesions in mouth
o Discomfort with certain foods
o Use of alcohol and tobacco
o Dentures
Physical Assessment of the GI System
Oral cavity
o Lips
o Gums
o Tongue
 ● Small‐bowel enteroscopy
● Endoscopy through an ostomy
Abdominal assessment; four quadrant ● Manometry and electrophysiologic
method studies
o Inspection
o Auscultation
o Percussion Patient Undergoing Gastroscopy
o Palpation

Question #3
Which is the correct order to complete an
abdominal
assessment?
A. Inspection, auscultation, percussion, and
palpation
B. Auscultation, inspection, palpation, and Colonoscopy and Flexible Fiber-Optic
percussion
Sigmoidoscopy
C. Percussion, palpation, inspection, and
auscultation
D. Palpation, percussion, auscultation, and
inspection

A. Inspection, auscultation, percussion,

and palpation
Rationale:
Auscultation must be completed before
manipulation of the abdomen because it has
an
impact on motility and can lead to an
inaccurate
interpretation of bowel sounds.

Diagnostic Tests of the GI System Question #4

● Serum laboratory studies Is the following statement true or
● Stool tests false?
● Breath tests When a colonoscopy is performed, the
● Abdominal ultrasonography flexible scope is
● Genetic testing passed through the rectum and sigmoid
● Imaging studies: CT, PET, MRI, colon into the
scintigraphy, virtual descending, transverse, and ascending
● colonoscopy colon.
● Upper GI tract study
● Lower GI tract study True
● GI motility studies Rationale:
● Endoscopic Procedures When a colonoscopy is performed, the
● EGD flexible scope is passed through the
● Colonoscopy rectum and sigmoid colon into the
● Anoscopy, proctoscopy, and
descending, transverse, and ascending
colon.
sigmoidoscopy
Nursing Interventions for GI Diagnostic
Tests
❖ Inform the primary provider of known
medical conditions or abnormal
laboratory values that may
affect the procedure
❖ Assess for adequate hydration
before, during, and immediately after
the procedure, and provide
education about maintenance of
hydration
❖ Provide health information and
procedural education to patients and
significant others
❖ Provide instructions about post
procedure care and
activity restrictions
❖ Help the patient cope with
discomfort and alleviate anxiety