A patient tells the nurse that even though at times he experiences a stomachache, after a few hours, the ache is gone and he feels fine. Which of the following might explain what the patient is describing to the nurse?
1. the duodenal pH of 4.0 killed the offending organism
2. the offending organism is killed by the acidic stomach environment
3. lack of mucous in the duodenum propelled the organism through the system
4. the offending organism is blocked by chyme
2
Rationale: The acidic environment of the stomach is unfavorable for pathogen growth. The acidic environment inhibits bacteria from entering the small intestine where the pH must remain 7.0 or greater. Offending organisms that survive the gastric acidity have difficulty adhering to the epithelial surface of the gastrointestinal tract in order to colonize and invade the gut wall. Peristaltic motility further inhibits pathogen attachment to the gut mucosa by pushing contents along; decreasing the amount of time for pathogens to colonize, preventing stagnation of chyme and preventing reflux of duodenal contents back up into the stomach.
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a. The patient is anxious about the test. b. The patient has an allergy to shellfish. c. The patient has back pain when lying flat. d. The patient drank apple juice 4 hours earlier.