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Gero Exam 2 > CH 18: Digestion and Bowel Elimination > Flashcards

CH 18: Digestion and Bowel Elimination Flashcards

1
Q

effects of aging on GI health

A

Tongue atrophies _ decreased taste sensation
Changes in taste sensation _ xerostomia, smoking, meds, diseases
Decreased saliva production _ difficulty with swallowing
Thinning of oral mucosa & weak mastication muscles _ decreased chewing efficiency
Gingival recession _ loosens tooth support
Presbyesophagus: weak esophageal contractions _ weakness of LES
Decreased esophageal and stomach motility _ food stays in upper GI longer _ indigestion, aspiration
Decreased elasticity of stomach _ reduces amount of food the stomach can accommodate
Reduced HCl, pancreatic, and pepsin acid _ gastric irritation, decreased mineral absorption, altered digestion of fats
Meds, inactivity, decreased peristalsis, reduced food and fluid _ Increased constipation
Decreased sensory perception _ unnoticed signal for bowel elimination; incomplete bowel emptying
Decreased liver size (but function remains stable) & reduced hepatic blood flow
Pancreas will atrophy and become fibrotic _ Reduced pancreatic secretions

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2
Q

GI health promotion in older adults

A

Increased fluid intake
Diet (fiber, fruits, veggies)
Establish a regular bowel pattern (preferably after breakfast)
Increased activity
Encourage complete bowel emptying
Astute assessment
Dental hygiene/Oral care

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3
Q

interventions and education for oral health in older adults

A

Brush all tooth surfaces and tongue twice a day with soft-bristled toothbrush and fluoridated toothpaste
Floss between teeth daily
Avoid mouthwash with alcohol
Avoid swabsticks (dry oral mucosa)
Remove dentures at night and soak them in water
Clean dentures and gums before putting dentures in the mouth
Use sugar free candy & gum
Visit a dentist every 6 months
Fluoride treatments to improve tooth enamel

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4
Q

dry mouth

A

Xerostomia

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5
Q

causes of xerostomia

A

reduced saliva, meds, mouth breathing, altered cognition

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6
Q

interventions for xerostomia

A

frequent mouth care
saliva substitutes
sipping water
sugarless candy/gum

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7
Q

dental problems come from

A

wear and tear
increased brittleness
finances
poor diet
aging
meds

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8
Q

dental problems can impact

A

food intake and appetite  malnutrition

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9
Q

interventions for dental problems

A

regular dental care and exams
consider finances of dental care
brushing (not swabs)
daily flossing
denture care
avoid trauma & commercial mouthwash (dilute)
further evaluate all lesions

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10
Q

causes of dysphagia in older adults

A

GERD, mechanical obstructions, and neuro disorders

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11
Q

types of dysphagia

A

Can be oropharyngeal or esophageal with varying symptoms

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12
Q

interventions for dysphagia

A

assessment of the symptoms
observe food intake
SLP
soft diet with thickened liquids
eat in upright position
ingest small bites at a time
verbal cues
monitor weight
suction available, etc.

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13
Q

cause of hiatal hernia in older adults

A

Incidence increases with age; due to low-fiber diet

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14
Q

symptoms of hiatal hernia

A

heartburn
dysphagia
belching
vomiting
regurgitation

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15
Q

interventions of hiatal hernia

A

weight reduction
bland diet
5-6 small meals,
sleep on side position
meds
sit up1 hour after eating
don’t eat 2 hours before bed
smoking cessation
avoid irritants

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16
Q

causes of esophageal cancer in older adults

A

connected to poor oral hygiene
smoking
alcohol
GERD (Barrett’s esophagus)

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17
Q

symptoms for esophageal cancer

A

dysphagia,
weight loss,
thirst,
excessive salivation,
hiccups,
anemia,
chronic
bleeding

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18
Q

interventions for esophageal cancer

A

Late diagnosis usually leads to surgical resection,
radiation,
chemo,
laser therapy,
photodynamic

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19
Q

causes of peptic ulcer

A

meds that increase gastric secretions,
stress,
diet (spicy or citrus foods),
smoking,
alcohol/beer,
caffeine,
H. Pylori

20
Q

s/s of peptic ulcer in older adults

A

pain,
bleeding,
obstruction,
perforation

21
Q

interventions of peptic ulcer

A

address causes
meds
dietary changes

22
Q

causes of stomach cancer

A

Cigarette use
ethnicity
intake of red meats

23
Q

s/s of stomach cancer

A

anorexia,
epigastric pain,
weight loss,
anemia,
but can be insidious and mistaken for indigestion

24
Q

interventions for stomach cancer

A

surgery
partial or total gastrectomy

25
Q

diverticulosis vs diverticulitis

A

Diverticulosis occurs when small defects in the muscle of the wall of the large intestine or colon allow small pockets or pouches (diverticula) to form.
Diverticulitis is infection or inflammation of these abnormal pouches.
Together, these conditions are called diverticular disease

26
Q

diverticulosis causes

A

Common in older adults due to chronic constipation, obesity, hiatal hernia, low-fiber and fluid intake, and atrophy of muscle walls

27
Q

interventions for diverticulosis

A

increase in dietary fiber
weight reduction
avoidance of constipation

28
Q

causes of diverticulitis

A

Occurs frequently with older men; due to overeating, straining, alcohol, irritating foods

29
Q

interventions for diverticulitis

A

reducing infection,
rest,
providing nutrition,
relieving discomfort,
IV therapy,
low-residue diet,
NPO,
surgery – colectomy or temporary colostomy

30
Q

s/s of colorectal cancer

A

bloody stools,
bowel pattern changes,
unexplained weight loss,
anorexia,
nausea,
abdominal pain,
anemia

31
Q

colostomy as treatment for colorectal cancer

A

Can cause issues for older adults – threatens positive self-concept
Further separates them from society’s view of normal
Major adjustment with dependency
Reduced energy, arthritic fingers, slow movement, and poor eyesight contribute to care
Continued follow-up

32
Q

causes of chronic constipation

A

inactive lifestyle,
low fiber and fluids,
depression,
laxative abuse (damaging the nerves),
certain meds,
dulled sensation of defecation,
failure to allow complete bowel emptying

can lead to fecal impaction

33
Q

interventions for chronic constipation

A

high fiber diet,
fluid intake,
regular activity,
regular bowel elimination time (mornings),
meds (after all else fails)

34
Q

important nursing considerations for laxatives

A

provide thorough education on the use of laxatives in order to prevent abuse and avoid a fluid and electrolyte imbalance

35
Q

interventions for flatulence

A

knee-chest for pain,
avoid flatus producing foods,
sit upright after a meal,
increased activity

36
Q

what is an intestinal obstruction and what are the causes

A

Impairment of GI flow due to cancer, adhesions, hernias, diverticulitis, UC, paralytic ileus

37
Q

interventions of intestinal obstruction

A

must be prompt,
bowel decompression,
surgery;
maintain F&E balance and ensure comfort

38
Q

tx of fecal impaction

A

due to constipation
prevent constipation,
digital removal (consult facility),
enema,
hydrogen peroxide in a rectal tube

39
Q

most common individuals with fecal incontinence

A

institutionalized older adults with fecal impaction who are physically/cognitively impaired

40
Q

causes of fecal incontinence

A

decreased contractile strength,
impaired automaticity of sphincters,
loss of cortical control,
decreased space in colon

41
Q

interventions for fecal incontinence

A

assess for presence of impaction,
bowel retraining,
meds,
surgery

42
Q

symptoms of acute appendicitis for older adults

A

Severe pain occurring in younger people MAY NOT occur with older adults. Older adults have minimal, referred pain; minimal fever and absence of leukocytosis  delayed diagnosis and treatment

43
Q

interventions for acute appendicitis

A

prompt surgery

44
Q

primarily affected age groups for pancreatic cancer

A

70-79 years old

45
Q

symptoms of pancreatic cancer

A

Fever may not be present;
generalized symptoms (anorexia, weakness, weight loss, nausea/vomiting, dyspepsia, belching, diarrhea, constipation, obstructive jaundice)

46
Q

interventions for pancreatic cancer

A

surgery
poor prognosis

47
Q

biliary tract disease treatment

A

Cholelithiasis = gallstones
increase with age
shock wave lithotripsy (stones); surgery (cancer; poor prognosis)

Gero Exam 2 (11 decks)

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