Week 3 - all 3 parts Flashcards
Causes of the changes in the GI tract :
Polypharmacy/Drugs, stress, poor nutrition, & poor hygiene
Changes in Oral cavity and pharynx
1- Periodontal gum diseases caused by bacterial infection lead to loss
of teeth and damage to the tissue surrounding the teeth and supporting
the bones.
2- Atrophy of the taste buds results in an inability to discriminate among
flavors (salt & sweet).
This may lead to decreased enjoyment of food resulting in poor eating habits and
nutritional deficiencies.
- Medications: reduced saliva production & oral lubrication > decreased protection of oral tissue
Age-related changes: Esophagus
Degeneration of the smooth muscles in the lower esophagus &/or Neurogenic , hormonal, & vascular changes
Decrease in the intensity of propulsive waves (esophageal contractions) & sphincter weakness
This condition is called Presbyesophagus
Signs and symptoms; Dysphagia, heartburn, vomiting of undigested food poor nutrition, dehydration & decreased food intake
Stomach
Degeneration of the gastric mucosa.
Decrease secretion of gastric acid & digestive enzymes, and decreased motility.
A decrease in pepsin may hinder protein digestion.
A decrease in hydrochloric acid and intrinsic factors leads to malabsorption of iron, vit B12, folic acid, and calcium.
→ Increase incidence of pernicious anemia, PUD, and stomach cancer.
Decreased motility & elasticity
The stomach is unable to accommodate large amounts of food because of decreased elasticity.
Delay in emptying food > early feeling of fullness & satiation.
Small intestine
Atrophy of the muscle and mucosal surfaces. & Thinning of the villi and decrease in epithelial cells.
This result in decrease in the absorption of fats and vitamin B12.
Large intestine
1- Atrophy of mucosa, the proliferation of connective tissue, and vascular changes (Atherosclerosis).
2- Decrease in the tone of the internal sphincter leads to incontinence or incomplete emptying of the bowel.
3- Nerve impulses that usually indicate the need to defecate may be diminished – this may increase the incidence of constipation.
4- The incidence of diverticula increases
Pancreas
1- Fibrosis, atrophy (but the size not affected), & fatty acid deposition.
2- Decrease in the volume of pancreatic secretions and enzyme output ( > age 40ys).
This decrease affects the digestion of fats and may account for vague intolerance of fatty food in older adults.
3- Increase in the incidence of pancreatic cancer as well as pancreatitis.
Liver:
1-Decrease in the size of the liver after age 50 (but liver function may remain within normal limits).
2-Decrease in hepatic blood flow (as a result of decreased cardiac output) and reduction in the hepatic enzymes.
The metabolism and detoxification of drugs become more difficult and decreased.
Patients become susceptible to drugs & toxins.
- Decreased ability to compensate for infections & immunologic & metabolic disorders.
Prevention of GI problems
Oral hygiene and preventive dental care.
Nutrition
Habits
Elimination
Sleep and rest
Common GI Symptoms
Nausea and Vomiting
Anorexia “lack of appetite”
Abdominal pain
Diarrhea
Constipation
Fecal incontinence -Involuntary passing of stool.
- Dysphagia is caused by:
a. Weak peristalsis of the duodenum
b. Ingestion of large amounts of food.
c. Failure of the esophageal sphincter to relax
d. Hiatal hernia
C
A nurse instructs a 78-year-old client with diarrhea to eat which of the following foods?
A. Apple and fried chicken
B. Avocado and hamburger
c. Toast and banana
D. Milk and Rice
C
Identify normal age-related changes in skin structure and function
Loss of thickness, elasticity, vascularity, and strength, can delay the healing process and increased the risk of skin tears and bruising
Increased lentigines النمش (brown-pigmented spots)
Loss of subcutaneous tissue causing wrinkling and sagging of skin affect self-esteem, temperature control, and drug efficacy (↓ absorption)
Loss of hair follicles along with thinning and graying
Increased hair density in nose and ears (in men) can clog the ear canal and impair hearing
Thicker nail with longitudinal lines
Decreased sebaceous and sweat gland activity affect thermoregulation and decreased sweating
Higher incidence of benign and malignant skin growth
Explain the Types of Benign skin growth
A. Cherry Angiomas:
Are common,
Are superficial vascular lesions (1-5 mm size)
begins at 30’s and increase in number.
S & S
Can be red bright or deep purple
Are Dome shaped
Present on trunk or anywhere in the body
Medically insignificant
B. Seborrheic keratosis
Common in older adults
Occurs in Sun exposed areas
S & S :
Scally growth, with a crumbly appearance
Borders may be round & smooth or irregular & notched
Lesion could be elevated
Diameter range from 2-3 mm
Vary in color from tan to brown to black
Treatment
Are removed for cosmetic reasons
C. Skin Tags:
Stack-like benign tumors
S & S
Are Tiny flesh-colored or brown
Develop into a long narrow stalk (up to 1cm)
Found on neck, axilla, eyelids, and groin
Treatment: Are removed on patient request for cosmetic reasons
Explain the Types of Inflammatory Dermatoses
A. . Seborrhiec Dermatitis
Common chronic inflammation of the skin associate with scaling
Risk Factors: Parkinson’s disease & stroke
S & S
Appears as white or yellow scale with a plaque like appearance
Has an erythematous red base
Mild itching
Begins in the scalp & moves down to eyebrows, chest with bilateral & symmetrical distribution
B. Intertrigo
A form of seborrheic dermatitis
Risk Factors: obese or DM
Result from the friction of opposing skin surfaces
S & S
Area is erythematous & itchy
Found in the armpit, inner aspects of the thighs, skin folds of the breast, and abdomen
Treatment :
Weight loss,
topical hydrocortisone and
clean and dry skin
C - Psoriasis
Is an autoimmune disease
Characterized by periods of remission & relapse with varying intensity
Can affect all ages
Risk Factors:
Arthritis
Myopathy
Enteropathy
Spondylitic heart diseases
AIDS
S & S
well conscribed pink plaques
covered silver –white loosely adherent scales
Clients may have changes in nails; yellow-brown discoloration with pitting, dimpling, separation of the nail plate from the underlying bed (oncylosis)
Can cause total body erythema & scaling
Can form a small pustule
May develop fever, leukocytosis, arthralgia,
secondary infections & electrolyte imbalance
