ASSESSMENT OF

GASTROINTESTINAL
SYSTEM
BY
SOUMYA
ASSESSMENT OF THE GASTROINTESTINAL
SYSTEM

Health history:
• GI assessment begins with complete history
 information about abdominal pain.(referred
pain)
 Gas, nausea and vomiting
 Diarrhea
 Constipation
 Fecal incontinence
PAST HEALTH, FAMILY AND SOCIAL HISTORY

Nurse ask’s about the:

• Brushing and flossing routine
• Frequency of dental visits
• Lesions or irritation in mouth, tongue or throat
• Recent history of sore throat or bloody sputum
• Discomfort
• Daily food intake
• Use of alcohol or tobacco(type, length of use,
amount and date of discontinuation)
• Past and current medication
• Previous Diagnostic tests, surgeries and
treatment
• Current nutritional status
• Appetite or eating patterns
• Unexplained weight loss or gain
• Laboratory tests
PHYSICAL ASSESSMENT

The physical examination includes assessment of

the mouth, abdomen and rectum
Requirements:
1. good source of light
2. full exposure of abdomen
3. Warm hands with short fingernails
4. Stethoscope
5. Tongue depressor
6. Gloves and mask
7. Patient with empty bladder
ORAL CAVITY EXAMINATION

Lips: inspect the lips for moisture, hydration,

color, texture, symmetry & the presence of
ulceration and fissures.
• Gums: check the inflammation, bleeding,
retraction and discoloration. Hard palate for colour
and shape. Mouth odour is also checked
• Tongue: texture, colour and lesions, symmetry and
strength.
• Pharynx: depress the tongue with the tongue
depressor and visualize pharynx, tonsils and
uvula.
ABDOMINAL EXAMINATION
Position: patient lies supine with knees flexed
slightly.
• The examination proceeds in the following
order:
1. inspection
2. Auscultation
3. Percussion
4. Palpation
POSITION
CONTI…..
Inspection Auscultation
• is performed first noting • always precedes percussion
• skin changes and palpation.
• Nodules • hear the sounds to
• Lesions determine the character,
• Scarring location and frequency of
• Discolorations bowel sounds
• Inflammation • They occur irregularly
• Bruising ranging from (5-35/min
CONTIN….

Percussion
• Percussion is used to assess
the size and density of the
abdominal organs.
• To detect the presence of
air filled, fluid filled or solid
masses
• All quadrants are percussed
for over all tympani and
dullness
Palpation
• Light palpation is used to
identify area of tenderness
and muscular resistance.
• Deep palpation is used to
identify masses
RECTAL INSPECTION AND PALPATION

The final part of the examination is the

evaluation of the terminal portion of the GI
tract.
• Requirement: gloves, water, soluble
lubrication, a penlight and drapes
• Positions for the rectal examination: knee
chest, left lateral with hips and knees flexed,
standing with hips flexed and upper body
supported by examination table.
POSITION
DIAGNOSTIC EVALUATION
GI diagnostic studies can confirm, rule out or
diagnose disease.
• General nursing interventions for the patients
who are undergoing a GI diagnostic evaluation.
1. Establishing the nursing diagnosis
2. Providing needed information about the test
and the activities required of the patient
3. Providing instruction about post procedure care
and activity restrictions
3. Providing health information and procedural
teaching to patients and significant others
4. Helping the patient cope with discomfort and
alleviating anxiety.
5. Informing the primary care provider of known
medical condition or abnormal laboratory values
that may affect the procedure.
6. Assessing for adequate hydration before, during,
and immediately after the procedure, and
providing education about maintenance of
hydration
DIAGNOSTIC TESTS
Serum laboratory studies
• Stool test
• Breath tests
• Abdominal ultrasonography
• DNA testing
• Imaging studies ( x-ray, contrast studies,
computed tomography CT, MRI, Positron
emission tomography PTI, colonoscopy.)
THANK YOU