T2: GI System (CH. 20) Flashcards
___ problems are the source of complaints and discomfort for older adults.
GI
___ can delay the diagnosis and treatment of specific pathogens.
Self-treatment
Atrophy of the __ affects __ __ and decreases taste sensation.
tongue
taste buds
____ production decreases, resulting in trouble swallowing.
saliva
___ results in weaker esophageal contractions and weakness of the sphincter.
Presbyesophagus
Esophageal and stomach ___ decreases.
motility
There is an increase risk for __ and indigestion.
aspiration
There is decreased __ of the stomach.
elasticity
Stomach has higher pH as a result of decline in ___ and ___.
hydrochloric acid and pepsin
A decline in hydrochloric acid causes an increase in the incidence of gastric __.
irritation
What interferes with absorption of calcium, iron, folic acid, and vitamin B12?
the decline in hydrochloric acid
What interferes with absorption of protein?
The decline in pepsin
Fewer cells on absorbing surface of ___ wall impact the absorption of dextrose, xylose, and vitamins B and D.
intestinal
Slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet increased the risk for ___.
constipation
Sensory perception decreases which may lead to __ or ___.
constipation or incomplete emptying of the bowel
___ salt synthesis decreases
Bile
Bile salt synthesis decreases which leads to ____.
Increase in the risk of gallstone development
The ___ changes affect the digestion of fats.
pancreas
What means “Dry Mouth”?
Xerostomia
What does Xerostomia result from?
Decreased saliva, some medications, Sjogren’s syndrome, mouth breathing, and altered cognition
How can you treat xerostomia? (3)
Saliva substitutes, sipping water, sugarless candy and gum
Which intervention will promote saliva production for the older adult living with xerostomia?
sucking on hard sugarless candy
Poor dentition can restrict food intake and lead to what two things?
- constipation
- malnutrition
What are 3 causes of Dysphagia?
Gastroesophageal reflux disease (GERD), stroke, and structural disorders
Incidence of swallowing difficulties __ with age.
increases
2 Goals of care and interventions for dysphagia?
Prevention of aspiration
Promotion of adequate nutritional status
Which medical problem may result in dysphagia?
GERD
Two types of hiatal hernia’s?
sliding (axial)
rolling (paraesophageal)
The ___ type is the most common type of hiatal hernia.
sliding
The __ type of hiatal hernia occurs when a part of the stomach and the junction of the stomach and esophagus slide through the diaphragm.
sliding
In the ___ type of hiatal hernia, the fundus and greater curvatures of the stomach roll up through the diaphragm.
rolling/paraesophageal
Symptoms of a hiatal hernia?
Heartburn, dysphagia, belching, vomiting, and regurgitation
There is some thought that the low-fiber diet of Americans contributes to the high prevalence of this condition.
hiatal hernia
Diagnosis is confirmed by a barium swallow and esophagoscopy.
hiatal hernia
Although the incidence has been decreasing, most persons affected by ____ are of advanced age.
cancer of the esophagus
The most common types of esophageal cancer are ___ and ___.
squamous cell carcinoma and adenocarcinoma.
This disease commonly strikes between the ages of 50 and 70 years and is of higher incidence in men.
esophageal cancer
African American men with a history of alcoholism and heavy smoking have a higher incidence of ____ esophageal carcinoma.
squamous cell
Poor oral hygiene and chronic irritation from tobacco, alcohol, and other agents contribute to the development of this problem.
esophageal cancer
__ __, a condition in which the normal lining of the esophagus is replaced by a type of lining usually found in the intestines (intestinal metaplasia).
Barrett’s esophagus
Barrett esophagus is associated with an increased risk of developing this cancer
esophageal cancer
Symptoms of esophageal cancer.
Dysphagia, weight loss, excessive salivation, thirst, hiccups, anemia, and chronic bleeding are symptoms of the disease
Symptoms of this disease are not recognized until the disease is advanced, contributing to a poor prognosis.
esophageal cancer
Causes of __ __:
Complication of COPD, meds that increase gastric secretion
peptic ulcers
Most common cause of adult onset of asthma?
meds that increase gastric secretion
Causes of this disease: Medications such as aspirin, or smoking, heavy alcohol, caffeine, stress, H-pylori infection, bleeding, obstruction, perforation, etc.
peptic ulcer disease
What foods can cause peptic ulcer disease?
Foods: High acidic foods, OJ, tomato sauce, chocolate, coffee
Signs of peptic ulcer disease?
Vomiting coffee ground emesis, pain, darker stools
Cancer of the Stomach: -High for what races? -More prevalent in \_\_, smokers, poor socioeconomic. -Average age of diagnosis is \_\_\_ Age ranges between \_\_-\_\_
- AA;s, Hispanic, and Asian Pacific Islanders
- men
- 69
- 50-70
___ account for most gastric malignancies.
Adenocarcinomas
Diet for prevention of cancer in stomach:
- low in red meat
- high in antioxidants
- high in chicken, turkey, (LEAN MEATS)
____: An abnormal punch formed at a weak point in the wall (GI tract)
Diverticulum
___: multiple punches of intestinal mucosa in the weakened muscular wall of large bowel
Diverticulosis
___: occur when this pouch is falloff fecal material and is now INFECTED & inflamed
Diverticulitis
Diverticular Disease most often occurs in the __ __.
sigmoid colon
T/F: Overeating, straining during a bowel movement, alcohol, and irritating foods may contribute to diverticulitis in the patient with diverticulosis.
True
Second most common malignancy in the United States.
Colorectal Cancer
Common sites of colorectal cancer are __ and __.
sigmoid colon and rectum
Interventions to promote bowel elimination:
Promote high fiber diet, fluid, regular activity, particular foods(prune juice, chocolate, pudding, raisins, prunes, dates, and currants)
___ used as LAST resort- can further cause dehydration
Laxatives
They may not recognize the sense to defecate (___ sensations) and it may be missed, so they will become backed up (___-cognitive related), failure to allow sufficient time for complete emptying of bowel.
dull
Alzheimers
How to avoid flatulence:
Avoid flatus producing foods, sitting upright after meals (allows gas to rise to the funds of stomach and expel), increase activity, knee to chest position.
Most often caused by cancer of colon, can also be from adhesions and hernias.
intestinal obstruction
Two types of intestinal obstruction:
Partial or complete
Partial or complete impairment of flow of intestinal contents in the __ intestines most often occurs due to cancer of the colon.
large
Adhesions and hernias are the primary cause of obstructions in the ___ intestine.
small
Maintain careful attention to bowel sounds by having patient ___ while listening. If it is absent, listen for 5 minutes.
lie
5
Nursing evaluation and assessment of an older adult with a new-onset of bowel obstruction will demonstrate what type of bowel sounds?
high-pitched bowel sounds
Prevention of ___ aids in avoiding fecal impaction.
constipation
A bowel elimination __ is essential.
record
Inability to voluntarily control the passage of stool
bowel incontinence
First step for bowel incontinence: ___
assess for impaction
Acute Appendicitis is ___ in older adults
Infrequent
Difficult to detect (until advanced stage): Cancer of the __
Pancreas
___ means gallstones.
Cholelithiasis
Cholelithiasis affects what gender more?
women
