GI and Renal Disorders Study Guide (2024-25) PDF

Common GASTROINTESTINAL Problems among the Elderly  DIVERTICULA 20% of over 60 years old a sac-like protrusion of the mucosa along the GIT unknown cause – may be related to lack of blood supply or nutrition of bowel in older adults...

Common GASTROINTESTINAL Problems among the Elderly  DIVERTICULA 20% of over 60 years old a sac-like protrusion of the mucosa along the GIT unknown cause – may be related to lack of blood supply or nutrition of bowel in older adults Risk factors – obesity – chronic constipation – LOW FIBER DIET – hiatal hernia  DIVERTICULITIS 15% DIVERTICULOSIS RESULTS TO DIVERTICULITIS INFLAMMATION OF OR AROUND A DIVERTICULAR SAC CAUSED BY RETENTION OF UNDIGESTED FOOD, STOOL AND BACTERIA DIAGNOSTICS: BARIUM ENEMA MANIFESTATION CONSTIPATION/ DIARRHEA LEFT SIDED QUADRANT PAIN MUCOUS AND/OR BLOOD IN THE STOOLS FLATULENCE, NAUSEA AND VOMITING COMPLICATION: PERITONITIS  CONSTIPATION ⮚ CONDITION WHICH THERE IS AN INFREQUENT PASSAGE OF DRY HARD STOOLS ⮚ DECREASE FREQUENCY OF BOWEL (AS COMPARED TO USUAL PATTERN) ⮚ CONTRIBUTING FACTORS: ✔ INACTIVE LIFESTYLE ✔ LOW FIBER AND LOW FLUID INTAKE ✔ DEPRESSION ✔ LAXATIVE ABUSE ✔ SOME MEDICATIONS  Nursing Diagnosis 1. CONSTIPATION RELATED TO DECREASED FLUID AND/OR BULK IN THE DIET 2. PAIN RELATED TO BOWEL OBSTRUCTION 3. KNOWLEDGE DEFICIT: DISEASE PROCESS, PREVENTION AND TREATMENT  Nursing Management EDUCATE NONPHARMACOLOGIC MEANS TO STIMULATE BOWEL MOVEMENT SUCH AS ROCKING TRUNK FROM SIDE TO SIDE WHILE SITTING ON TOILET HIGH FIBER DIET ADEQUATE FLUID STATUS (2000ML/DAY) PAIN MANAGEMENT ANTISPASMODICS, ANALGESICS BOWEL REST (IV FLUIDS AND NPO STATUS)  Principles of Bowel Programs to prevent Constipation START WITH A CLEAN BOWEL PRIOR TO INITIATING A PROGRAM OR PROTOCOL. TRY ALL NATURAL MEANS FIRST: FIBER, FLUIDS, ACTIVITY, TIMING, POSITIONING. BE SURE THE PERSON IS TAKING ADEQUATE FIBER AND FLUIDS BEFORE ADDING MEDICATIONS. STOOL SOFTENERS ARE GIVEN FOR HARDENED STOOL AND THE PERSON MUST  ▪ PERISTALTIC STIMULATORS ▪ Principles of Bowel Programs to SUPPOSITORIES ▪ prevent Constipation BULK-FORMERS AVOID THE USE OF BEDPANS—HAVE THE PERSON SIT UPRIGHT ON THE TOILET OR COMMODE. AVOID THE REGULAR USE OF ENEMAS.  STOMACH CANCER Insidious often seen in older men age 65–74 Unknown cause, contributed by H. pylori infection Mimics ulcers and gastritis – Symptoms are vague until cancer has spread throughout the body – Epigastric pain, anorexia, nausea, and difficulty swallowing, weight loss  STOMACH CANCER POOR PROGNOSIS 5% TO 15 % 5-YEAR SURVIVAL PREVENTION A DIET LOW IN RED MEATS RISK (RISK DOUBLES IF EATING RED MEAT >13 TIMES A WEEK) HIGHER IN ANTIOXIDANTS HAS A PROTECTIVE EARLY TESTING  PANCREATIC CANCER FOUND MORE OFTEN IN OLDER ADULTS STRIKES THOSE BETWEEN 60 AND 80 YEARS OF AGE POOR PROGNOSIS FEWER THAN 20% SURVIVE AFTER 1 YEAR OF DIAGNOSIS AND ONLY 3% 5- YEAR SURVIVAL RATE  PANCREATIC CANCER Risk factors: – Cigarette smoking – family history – diabetes Symptoms – Generally occur late in the course – 90% individuals have metastases upon diagnosis Nausea, vomiting, anorexia weight loss, depression excessive belching Jaundice and itching  Nursing Diagnosis 1. ANTICIPATORY GRIEVING RELATED TO POOR PROGNOSIS 2. ALTERED NUTRITION: LESS THAN BODY REQUIREMENTS RELATED TO GASTRIC DISTRESS 3. PAIN RELATED TO ABDOMINAL DISCOMFORT 4. INEFFECTIVE FAMILY OR INDIVIDUAL COPING RELATED TO TERMINAL DIAGNOSIS  Management PALLIATIVE SURGERY AN OPTION IN TYPES/LOCATIONS OF TUMORS NARCOTIC ANALGESICS ANTIHISTAMINES OBTAIN HOSPICE SERVICES AS EARLY AS POSSIBLE WHEN THE PROGNOSIS IS TERMINAL  Common RENAL Problems among the Elderly  URINARY INCONTINENCE Incontinence-Urinary Incontinence (UI) is defined as involuntary leakage of urine. Causing social and hygienic problem INVOLUNTARY LEAKAGE OF URINE AFFECTING 30% OF THE ELDERLY USUALLY AFFECTS WOMEN (DUE TO STRUCTURAL Stress CHANGES AND HORMONAL CHANGES DURING MENOPAUSE Urinary Chronic Urge Incontinen ce Acute Overflow  Stress OCCURS WHEN THE PRESSURE IN THE BLADDER EXCEEDS URETHRAL RESISTANCE WHEN INTRAABDOMINAL PRESSURE INCREASES IN THE ABSENCE OF A DETRUSOR CONTRACTION.  Stress COMMON IN OLDER WOMEN -the female urethra is shorter than the male urethra DUE TO SUDDEN INCREASE IN ABDOMINAL PRESSURE RESULTS FROM MULTIPLE PREGNANCIES, OBESITY, OR SURGERY TRIGGERED BY LAUGHING, SNEEZING, COUGHING, OR STRAINING OF ABDOMINAL MUSCLES  Urge INVOLUNTARY LOSS OF URINE ASSOCIATED WITH STRONG DESIRE TO VOID The bladder (detrusor) escapes normal cerebral inhibition and contracts spontaneously Common type among frail older adults related to birth defects, UTI, spine or nerve damage, immobility, prostate problems, overactive bladder, or pelvic cancer  Overflow ACCOUNTS FOR