GI Flashcards
GI changes in elderly
1.decreased hydrochloric acid, peristalsis, lipase production, protein synthesis, and liver enzymes
physical assessment of abdomen
inspection, auscultation, percussion, palpation
elderly diet changes
small frequent meals high in fiber, vitamins, and iron w plenty of water
large pulsating mass in abdomen
don’t touch, tell dr quadrant of origin and direction of flow
-intestinal obstruction of aortic aneurysm
range of bowel sounds
use diaphragm of stethescope
hypo- after abdominal surgery , peritonitis, paralytic ulcer
borborygmus
loud increased sounds- diarrhea
bruits
swoosh sound- aneurysm
upper endoscopy interventions for decreased RR
use a stimulus such as sternal rub to encourage deeper and faster respirations
colonoscopy education
- clear liquid diet
- avoid red, orange or purple beverages
- drink electrolyte drinks
- NPO 4-6 hrs before proceedure
- avoid aspirin, anticoagulants, and antiplatelets several days prior
- bowel prep- chill, no elderly
candida albicans (oral thrush) treatment
nystatin (mycostantin) oral suspension swish/swallow
ice pop troches
topical triamcinolone in benzocaine
oral dexamethasone
erythroplakia
precancerous, red velvety mucosal lesions on the surface of oral mucosa
leukoplakia
thick white firmly attached patches that can’t be easily scraped off
lidocaine for pain cautions
can cause burns from hot liquids or risk for chocking
acute sialadentis interventions
IV fluids/hydration, warm compress, massage of the gland, use saliva substitute, use sialagogues (lemon or citrus flavor)
contributing factors to decreased lower esophageal sphincter
caffiene, chocolate, citrus, tomatoes, smoking, calcium channel blockers, nitrates, mint, alcohol, anticholenergic drugs, high levels of estrogen/progesterone, NG tube placement
GERD symptoms
dyspepsia, regurgitation, cough/wheeze at night, water brash, dysphagia, odynophagia, epigastric pain, belch/fart, nausea, pyrosis (heartburn), globus (feeling of something in back of throat), pharyngitis
peptic ulcer disease diet
avoid substances that increase gastric acid secretion- caffeine containing beverages and all coffee
antacid side effects
sodium excess, hypernatremia, water retention, metabolic alkalosis, acid rebound, diarrhea, constipation
dyspepsia
heartburn
pernicious anemia vitamin supplementation
B12
helicobacter infection meds (MOC)
triple therapy- metronidazole (amoxicillin), omeprazole (lansoprazole), and clarithomycin
quad- add PPI
liver disease and increased bleeding
PT is prolonged because the liver decreases production of prothrombin, low platelet counts
splenomegally destroys platelets causing thrombocytopenia
hepatic encephalopathy cause
shunting of portal venous blood into central circulation so the liver is bypassed
hepatic encephalopathy
cognitive syndrome that results from liver failure and cirrhosis
- sleep/mood/speech disturbance early -treatable
- LOC and neuromuscular later
beta cells in pancrease
insulin
alpha cells
glucagon
3 pancreas enzymes
lipase, trypsin, elastase
omeprazole
30 min before meal, take whole
- long term use osteoporotic fractures and reduced aniplatelet drug clopidogrel effect
- don’t stop abruptly
