Digestion, Nutrition, Urinary Function

Question 1

Age-related changes for Digestion

Answer 1

• less efficient/effective chewing
• reduced senses of taste and smell
• reduced saliva (usually r/t anticholinergic use)
• slower swallowing (presbyphagia due to stiffening of esophagus)
• slower GI motility (peristalsis) and intestinal tract has reduced blood flow
• less effective conversion of food to nutrients
• reduced BF to liver
• decreased responsiveness of pancreatic beta cells to glucose
• increased susceptibility to gallstones

Question 2

Pathologic conditions for Digestion and Nutrition

Answer 2

Constipation
- decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or excessively hard, dry stool
- 15-30% of those in community
- 75-80% of those in institutional communities

Dysphasia
- difficulty swallowing is a common outcome of a CVA/Stroke

C. diff
- bacterium causing diarrhea

Question 3

Changes to daily intake of OAs

Answer 3

need fewer but higher-quality calories (nutritional density) - provide 55% calories from complex carbs

Question 4

Age related changes to Nutritional Requirements

Answer 4

• muscle mass declines
• unhealthy abdominal fat distribution increases risk for heart disease and diabetes
• decreased thirst perception

Question 5

Eating alone is associated with a ___ decline in caloric intake

Answer 5

30%

Question 6

Heath education regarding constipation

Answer 6

• each adult has an individual pattern of BMs (range of 3 QD to 2 weekly)
• high-fibre foods: fresh, uncooked fruits and vegetables, bran, whole grains
• 8-10 cups of noncaffeinated liquids daily
• avoid laxatives and use dietary changes
• respond to the urge to defecate immediately
• exercise regularly
• if med is necessary, use a bulk-forming agent

Question 7

Normal BMI range

Answer 7

18.5 to 24.9

Question 8

3 Functional consequences of Urinary Function

Answer 8

Effects on renal function (contributes to increased drug interactions and adverse med reactions)
- impaired absorption of calcium
- predisposition to hyponatremia and hyperkalemia
- diminished ability to maintain fluid and electrolyte balance
- pH imbalances

Effects on voiding patterns
- bladder capacity is smaller
- bladder empties incompletely, retains residual urine
- nocturia

Urinary incontinence
- categorized into potential for treatment and established (chronic)

Question 9

3 Pathologic conditions affecting Urinary Wellness

Answer 9

UTIs
- risks: urinary incontinence and frequency, impaired cognitive processing, increased age, indwelling catheter
- symptoms: mental status changes, suprapubic pain, urinary frequency and or dysuria (discomfort)
- treatment: antibiotics

BPH (benign prostatic hyperplasia/enlargement that obstructs urethra vesical neck)
- symptoms: decreased urine flow, incomplete bladder emptying, urinary urgency and frequency
- treatment: meds and surgery

Paraphimosis (emergency where retracted foreskin can not be returned)
- symptoms: pain or agitation
- treatment: manual return or surgery
NOTE: always reposition foreskin after cleaning an uncircumcised male