T2: GI System (CH. 20)

Question 1

___ problems are the source of complaints and discomfort for older adults.

Answer 1

GI

Question 2

___ can delay the diagnosis and treatment of specific pathogens.

Answer 2

Self-treatment

Question 3

Atrophy of the __ affects __ __ and decreases taste sensation.

Answer 3

tongue

taste buds

Question 4

____ production decreases, resulting in trouble swallowing.

Answer 4

saliva

Question 5

___ results in weaker esophageal contractions and weakness of the sphincter.

Answer 5

Presbyesophagus

Question 6

Esophageal and stomach ___ decreases.

Answer 6

motility

Question 7

There is an increase risk for __ and indigestion.

Answer 7

aspiration

Question 8

There is decreased __ of the stomach.

Answer 8

elasticity

Question 9

Stomach has higher pH as a result of decline in ___ and ___.

Answer 9

hydrochloric acid and pepsin

Question 10

A decline in hydrochloric acid causes an increase in the incidence of gastric __.

Answer 10

irritation

Question 11

What interferes with absorption of calcium, iron, folic acid, and vitamin B12?

Answer 11

the decline in hydrochloric acid

Question 12

What interferes with absorption of protein?

Answer 12

The decline in pepsin

Question 13

Fewer cells on absorbing surface of ___ wall impact the absorption of dextrose, xylose, and vitamins B and D.

Answer 13

intestinal

Question 14

Slower peristalsis, inactivity, reduced food/fluid intake, drugs, and low-fiber diet increased the risk for ___.

Answer 14

constipation

Question 15

Sensory perception decreases which may lead to __ or ___.

Answer 15

constipation or incomplete emptying of the bowel

Question 16

___ salt synthesis decreases

Answer 16

Bile

Question 17

Bile salt synthesis decreases which leads to ____.

Answer 17

Increase in the risk of gallstone development

Question 18

The ___ changes affect the digestion of fats.

Answer 18

pancreas

Question 19

What means “Dry Mouth”?

Answer 19

Xerostomia

Question 20

What does Xerostomia result from?

Answer 20

Decreased saliva, some medications, Sjogren’s syndrome, mouth breathing, and altered cognition

Question 21

How can you treat xerostomia? (3)

Answer 21

Saliva substitutes, sipping water, sugarless candy and gum

Question 22

Which intervention will promote saliva production for the older adult living with xerostomia?

Answer 22

sucking on hard sugarless candy

Question 23

Poor dentition can restrict food intake and lead to what two things?

Answer 23

• constipation

- malnutrition

Question 24

What are 3 causes of Dysphagia?

Answer 24

Gastroesophageal reflux disease (GERD), stroke, and structural disorders

Question 25

Incidence of swallowing difficulties __ with age.

Answer 25

increases

Question 26

2 Goals of care and interventions for dysphagia?

Answer 26

Prevention of aspiration | Promotion of adequate nutritional status

Question 27

Which medical problem may result in dysphagia?

Answer 27

GERD

Question 28

Two types of hiatal hernia's?

Answer 28

sliding (axial) | rolling (paraesophageal)

Question 29

The ___ type is the most common type of hiatal hernia.

Answer 29

sliding

Question 30

The __ type of hiatal hernia occurs when a part of the stomach and the junction of the stomach and esophagus slide through the diaphragm.

Answer 30

sliding

Question 31

In the ___ type of hiatal hernia, the fundus and greater curvatures of the stomach roll up through the diaphragm.

Answer 31

rolling/paraesophageal

Question 32

Symptoms of a hiatal hernia?

Answer 32

Heartburn, dysphagia, belching, vomiting, and regurgitation

Question 33

There is some thought that the low-fiber diet of Americans contributes to the high prevalence of this condition.

Answer 33

hiatal hernia

Question 34

Diagnosis is confirmed by a barium swallow and esophagoscopy.

Answer 34

hiatal hernia

Question 35

Although the incidence has been decreasing, most persons affected by ____ are of advanced age.

Answer 35

cancer of the esophagus

Question 36

The most common types of esophageal cancer are ___ and ___.

Answer 36

squamous cell carcinoma and adenocarcinoma.

Question 37

This disease commonly strikes between the ages of 50 and 70 years and is of higher incidence in men.

Answer 37

esophageal cancer

Question 38

African American men with a history of alcoholism and heavy smoking have a higher incidence of ____ esophageal carcinoma.

Answer 38

squamous cell

Question 39

Poor oral hygiene and chronic irritation from tobacco, alcohol, and other agents contribute to the development of this problem.

Answer 39

esophageal cancer

Question 40

__ __, a condition in which the normal lining of the esophagus is replaced by a type of lining usually found in the intestines (intestinal metaplasia).

Answer 40

Barrett’s esophagus

Question 41

Barrett esophagus is associated with an increased risk of developing this cancer

Answer 41

esophageal cancer

Question 42

Symptoms of esophageal cancer.

Answer 42

Dysphagia, weight loss, excessive salivation, thirst, hiccups, anemia, and chronic bleeding are symptoms of the disease

Question 43

Symptoms of this disease are not recognized until the disease is advanced, contributing to a poor prognosis.

Answer 43

esophageal cancer

Question 44

Causes of __ __: | Complication of COPD, meds that increase gastric secretion

Answer 44

peptic ulcers

Question 45

Most common cause of adult onset of asthma?

Answer 45

meds that increase gastric secretion

Question 46

Causes of this disease: Medications such as aspirin, or smoking, heavy alcohol, caffeine, stress, H-pylori infection, bleeding, obstruction, perforation, etc.

Answer 46

peptic ulcer disease

Question 47

What foods can cause peptic ulcer disease?

Answer 47

Foods: High acidic foods, OJ, tomato sauce, chocolate, coffee

Question 48

Signs of peptic ulcer disease?

Answer 48

Vomiting coffee ground emesis, pain, darker stools

Question 49

``` Cancer of the Stomach: -High for what races? -More prevalent in __, smokers, poor socioeconomic. -Average age of diagnosis is ___ Age ranges between __-__ ```

Answer 49

- AA;s, Hispanic, and Asian Pacific Islanders - men - 69 - 50-70

Question 50

___ account for most gastric malignancies.

Answer 50

Adenocarcinomas

Question 51

Diet for prevention of cancer in stomach:

Answer 51

- low in red meat - high in antioxidants - high in chicken, turkey, (LEAN MEATS)

Question 52

____: An abnormal punch formed at a weak point in the wall (GI tract)

Answer 52

Diverticulum

Question 53

___: multiple punches of intestinal mucosa in the weakened muscular wall of large bowel

Answer 53

Diverticulosis

Question 54

___: occur when this pouch is falloff fecal material and is now INFECTED & inflamed

Answer 54

Diverticulitis

Question 55

Diverticular Disease most often occurs in the __ __.

Answer 55

sigmoid colon

Question 56

T/F: Overeating, straining during a bowel movement, alcohol, and irritating foods may contribute to diverticulitis in the patient with diverticulosis.

Answer 56

True

Question 57

Second most common malignancy in the United States.

Answer 57

Colorectal Cancer

Question 58

Common sites of colorectal cancer are __ and __.

Answer 58

sigmoid colon and rectum

Question 59

Interventions to promote bowel elimination:

Answer 59

Promote high fiber diet, fluid, regular activity, particular foods(prune juice, chocolate, pudding, raisins, prunes, dates, and currants)

Question 60

___ used as LAST resort- can further cause dehydration

Answer 60

Laxatives

Question 61

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.

Answer 61

dull | Alzheimers

Question 62

How to avoid flatulence:

Answer 62

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.

Question 63

Most often caused by cancer of colon, can also be from adhesions and hernias.

Answer 63

intestinal obstruction

Question 64

Two types of intestinal obstruction:

Answer 64

Partial or complete

Question 65

Partial or complete impairment of flow of intestinal contents in the __ intestines most often occurs due to cancer of the colon.

Answer 65

large

Question 66

Adhesions and hernias are the primary cause of obstructions in the ___ intestine.

Answer 66

small

Question 67

Maintain careful attention to bowel sounds by having patient ___ while listening. If it is absent, listen for 5 minutes.

Answer 67

lie | 5

Question 68

Nursing evaluation and assessment of an older adult with a new-onset of bowel obstruction will demonstrate what type of bowel sounds?

Answer 68

high-pitched bowel sounds

Question 69

Prevention of ___ aids in avoiding fecal impaction.

Answer 69

constipation

Question 70

A bowel elimination __ is essential.

Answer 70

record

Question 71

Inability to voluntarily control the passage of stool

Answer 71

bowel incontinence

Question 72

First step for bowel incontinence: ___

Answer 72

assess for impaction

Question 73

Acute Appendicitis is ___ in older adults

Answer 73

Infrequent

Question 74

Difficult to detect (until advanced stage): Cancer of the __

Answer 74

Pancreas

Question 75

___ means gallstones.

Answer 75

Cholelithiasis

Question 76

Cholelithiasis affects what gender more?

Answer 76

women