Transcript Airgas template

Chapter 26
Gastrointestinal Conditions
Gastrointestinal Problems
• Indigestion
• Belching
• Diarrhea
• Constipation
• Nausea
• Vomiting
• Anorexia
• Weight gain or loss
• Flatulence
Factors Influencing Gastrointestinal Tract
Health
• Poor nutrition
• Medications
• Emotions
• Inactivity
• A variety of other factors
Causes of Anorexia
• Medication side effects
• Inactivity
• Physical illness
• Age-related changes
• Anxiety and depression
Management of Anorexia
• Depending on the cause, treatment could consist:
– A high-calorie diet
– Referral to social programs
– Tube feeding
– Hyperalimentation
– Psychiatric therapy
– Medications
Xerostomia (Dry Mouth)
• Causes:
– Drugs
– Sjogren’s syndrome
– Mouth breathing
– Altered cognition
• Interventions:
– Sipping water
– Hard candies
– Saliva substitutes
Factors That Could Lead to Poor Dental
Status in Elders
• Limited funds
• Lack of knowledge
• Diseases
• Fear of Dentists
Causes of Dysphagia
• Gastroesophageal reflux disease (GERD)
• Stroke
• Structural disorders
Types of Dysphagia
• Oropharyngeal
– Difficulty transferring food from the mouth into the
the pharynx and esophagus.
• Esophageal
– Difficulty transferring food down the esophagus.
Interview Questions for Patients with
Dysphagia
• When did the problem begin?
• What other symptoms accompany the dysphagia?
• What types of foods are most problematic?
• Is the problem intermittent or present with every meal?
Types of Hiatal Hernias
• Sliding (axial)
– A part of the stomach and the junction of the
stomach and esophagus slide through the
diaphragm.
• Rolling (paraesophageal)
– The fundus and greater curvatures of the stomach
roll up through the diaphragm.
Symptoms of Hiatal Hernias
• Heartburn
• Dysphagia
• Belching
• Vomiting
• Regurgitation
Symptoms of Esophageal Cancer
• Dysphagia
• Weight loss
• Excessive salivation
• Thirst
• Hiccups
• Anemia
• Chronic bleeding
Factors Contributing to Peptic Ulcers
• Stress
• Diet
• Genetic predisposition
• Longevity
• More precise diagnostic evaluation
• Increasing prevalence of chronic obstructive pulmonary
disease
Symptoms of Peptic Ulcers
• Pain
• Bleeding
• Obstruction
• Perforation
Complications of Peptic Ulcers
• Constipation or diarrhea caused by antacid therapy
• Pyloric obstruction resulting in dehydration, peritonitis,
hemorrhage, and shock
Factors Causing Stomach Cancer to Be
Common Problem in Late Life
• Chronic constipation
• Obesity
• Age-related atrophy of intestinal walls
• Low-fiber diet
Factors Contributing to Diverticular
Disease
• Chronic constipation
• Obesity
• Hiatal hernia
• Atrophy of the intestinal wall muscles with aging
Medical Management of Diverticular
Disease
• Increase in dietary fiber intake
• Weight reduction
• Avoidance of constipation
Factors Contributing to Diverticulitis
• Overeating
• Straining during a bowel movement
• Alcohol
• Irritating foods
Nursing Interventions for Diverticulitis
• Acute Phase
– Reduce infection.
– Provide nutrition.
– Relieve discomfort.
– Promote rest.
• Following Acute Phase
– Consume a low-residue diet.
Symptoms of Cancer of the Colon
• Bloody stools
• Change in bowel function
• Anorexia
• Nausea
• Epigastric pain
• Jaundice
Screening Measures for Colon Cancer
• Digital rectal examination
• Fecal occult blood testing
• Barium enema
• Sigmoidoscopy with biopsy
Factors Contributing to Chronic
Constipation
• An inactive lifestyle
• Low fiber and fluid intake
• Depression
• Laxative abuse
• Certain medications
• Dulled sensations for bowel elimination
• Failure to allow sufficient time for complete emptying of
the bowel
Measures to Promote Bowel Elimination
• Scheduling a regular time for it.
• Incorporating high-fiber foods into the diet.
• Rocking the trunk from side to side and back and forth
while sitting on the toilet.
Causes of Bowel Obstruction
• Cancer of the colon
• Diverticulitis
• Ulcerative colitis
• Hypokalemia
• Vascular problems
• Paralytic ileus
Symptoms of Bowel Obstruction
• Small Bowel Obstruction
– Upper and midabdominal pain in rhythmic recurring
waves; vomiting may occur.
• Obstructions Occuring Past the Ileum
– Abdominal distension so severe that the raised
diaphragm can inhibit respirations.
– Vomiting is more severe.
Symptoms of Bowel Obstruction (cont.)
• Obstruction of the Colon
– Lower abdominal pain, altered bowel habits,
distension, and a sensation of the need to defecate.
Vomiting usually does not occur until late.
Possible Causes of Incontinence
• Decreased contractile strength
• Impaired automaticity of the puborectal and external
anal sphincter
• Reduced reservoir capacity
Symptoms of Pancreatic Cancer
• Anorexia
• Weakness
• Weight loss and wasting
• Dyspepsia
• Belching
• Nausea
• Vomiting
Symptoms of Pancreatic Cancer (cont.)
• Diarrhea
• Constipation
• Obstructive jaundice
• Fever may or may not be present.
• Epigastric pain radiating to the back may be experienced.
Treatment Measures for Biliary Tract
Disease
• Nonsurgical Therapies
– Rotary lithotrite treatment
– Extracorporeal shock wave lithotripsy
• Standard Surgical Procedures
Source
• Eliopoulos, C. (2005). Gerontological Nursing, (6th
ed.). Philadelphia: Lippincott, Williams & Wilkins (ISBN
0-7817-4428-8).