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Chapter 26 Gastrointestinal Conditions

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

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Chapter 26 Gastrointestinal Conditions

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  1. Chapter 26Gastrointestinal Conditions

  2. Gastrointestinal Problems • Indigestion • Belching • Diarrhea • Constipation • Nausea • Vomiting • Anorexia • Weight gain or loss • Flatulence

  3. Factors Influencing Gastrointestinal Tract Health • Poor nutrition • Medications • Emotions • Inactivity • A variety of other factors

  4. Causes of Anorexia • Medication side effects • Inactivity • Physical illness • Age-related changes • Anxiety and depression

  5. Management of Anorexia • Depending on the cause, treatment could consist: • A high-calorie diet • Referral to social programs • Tube feeding • Hyperalimentation • Psychiatric therapy • Medications

  6. Xerostomia (Dry Mouth) • Causes: • Drugs • Sjogren’s syndrome • Mouth breathing • Altered cognition • Interventions: • Sipping water • Hard candies • Saliva substitutes

  7. Factors That Could Lead to Poor Dental Status in Elders • Limited funds • Lack of knowledge • Diseases • Fear of Dentists

  8. Causes of Dysphagia • Gastroesophageal reflux disease (GERD) • Stroke • Structural disorders

  9. Types of Dysphagia • Oropharyngeal • Difficulty transferring food from the mouth into the the pharynx and esophagus. • Esophageal • Difficulty transferring food down the esophagus.

  10. 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?

  11. 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.

  12. Symptoms of Hiatal Hernias • Heartburn • Dysphagia • Belching • Vomiting • Regurgitation

  13. Symptoms of Esophageal Cancer • Dysphagia • Weight loss • Excessive salivation • Thirst • Hiccups • Anemia • Chronic bleeding

  14. Factors Contributing to Peptic Ulcers • Stress • Diet • Genetic predisposition • Longevity • More precise diagnostic evaluation • Increasing prevalence of chronic obstructive pulmonary disease

  15. Symptoms of Peptic Ulcers • Pain • Bleeding • Obstruction • Perforation

  16. Complications of Peptic Ulcers • Constipation or diarrhea caused by antacid therapy • Pyloric obstruction resulting in dehydration, peritonitis, hemorrhage, and shock

  17. Factors Causing Stomach Cancer to Be Common Problem in Late Life • Chronic constipation • Obesity • Age-related atrophy of intestinal walls • Low-fiber diet

  18. Factors Contributing to Diverticular Disease • Chronic constipation • Obesity • Hiatal hernia • Atrophy of the intestinal wall muscles with aging

  19. Medical Management of Diverticular Disease • Increase in dietary fiber intake • Weight reduction • Avoidance of constipation

  20. Factors Contributing to Diverticulitis • Overeating • Straining during a bowel movement • Alcohol • Irritating foods

  21. Nursing Interventions for Diverticulitis • Acute Phase • Reduce infection. • Provide nutrition. • Relieve discomfort. • Promote rest. • Following Acute Phase • Consume a low-residue diet.

  22. Symptoms of Cancer of the Colon • Bloody stools • Change in bowel function • Anorexia • Nausea • Epigastric pain • Jaundice

  23. Screening Measures for Colon Cancer • Digital rectal examination • Fecal occult blood testing • Barium enema • Sigmoidoscopy with biopsy

  24. 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

  25. 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.

  26. Causes of Bowel Obstruction • Cancer of the colon • Diverticulitis • Ulcerative colitis • Hypokalemia • Vascular problems • Paralytic ileus

  27. 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.

  28. 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.

  29. Possible Causes of Incontinence • Decreased contractile strength • Impaired automaticity of the puborectal and external anal sphincter • Reduced reservoir capacity

  30. Symptoms of Pancreatic Cancer • Anorexia • Weakness • Weight loss and wasting • Dyspepsia • Belching • Nausea • Vomiting

  31. 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.

  32. Treatment Measures for Biliary Tract Disease • Nonsurgical Therapies • Rotary lithotrite treatment • Extracorporeal shock wave lithotripsy • Standard Surgical Procedures

  33. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).

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