GI Outline - Study Guide

Topics: Stomach, Peptic ulcer, Abdominal pain Pages: 16 (5346 words) Published: October 12, 2013
Normal and abnormal changes within the GI system for the elderly (905) Mouth: gingival retraction, decreased taste buds, decreases sense of smell, decrease volume of saliva, atrophy of gingival tissue; loss of teeth, dentures, difficulty chewing, diminished sense of taste, dry oral mucosa, poor fitting dentures Esophagus: lower esophageal sphincter pressure decreases, motility decreases; epigastric distress, dysphagia, potential for hiatal hernia and aspiration ABD wall: thinner and less taut, decreased number and sensitivity of sensory receptors; more visible peristalsis, easier palpation or organs, less sensitivity to surface pain Stomach: atrophy of gastric mucosa, decreased blood flow; food intolerances, signs of anemia as a result of cobalamin malabsorption, decreased gastric emptying Small Intestines: slighted decreased secretion of most digestive enzymes and motility; complaints of indigestion, slowed intestinal absorption of fat-soluble vitamins Liver: decrease size and lowered in position, decreased protein synthesis, ability to regenerate decreased; easier palpation to lower border extending past costal margin, decreased drug and hormone metabolism Large Intestine, Anus, Rectum: decreased anal sphincter tone and nerve supply to rectal area, decreased muscular tone and motility, increased transit time, sensation to defecation decreases; fecal incontinence, flatulence, abd distention, relaxed perineal musculature constipation, fecal impaction Pancreas: pancreatic ducts distended, lipase production decreased, pancreatic reserve impaired; impaired fat absorption, decreased glucose tolerance. The process of aging changes the functional ability of the GI system, less than any other organ systems. Diet, alcohol and obesity affect organs of the GI separately from aging. Tooth enamel and dentin wear down making teeth susceptible to cavities. Periodnal diasease can leed to loss of teeth. Xerostomia, decreased saliva production, may be associated with dysphagia. Taste buds, sense of smell and salivary secreation dimish causing a decrease in appetite and eating less enjoyable. Incompetent lower esophageal sphincter causes delayed emptying maybe causing GERD. Motility decreases cause reduced absorption. Decreased HCl and delayed gastric emptying causes gastritis. Liver size decreases after 50 but maintains enzymes. Those over 85 are at risk for decreased food intake due to limited budgets or means. (968) The older adult experiencing V/V requires carful assessment and monitoring particularly during periods of fluid loss and subsequent rehydration therapy. Older patients are more likely to have cardiac or renal insufficiency that places them at greater risk for life-threatening fluid and electrolyte imbalances. Excessive replacement of fluid and electrolytes may result in adverse consequences for the person who has HF or renal disease. Decreased LOC may be at high risk for aspiration of vomit; monitor the patient’s physical status and LOC during vomiting. Elderly are susceptible to CNS side effects of antiemetic drugs – confusion; monitor safety. (976) Incidence of hiatal hernia and GERD increase with age. Hiatal hernia is associated with weakening of the diaphragm, obesity, kyphosis or other factors (ie. Wearing girdles). Medications commonly taken by older patients including nitates, CCBs, antidepressants, decrease LES pressure. NSAIDs & potassium can irritate the esophageal mucosa. Some older adults with hiatal hernia and GERD are asymptomatic or have less sever symptoms. The first indications may include esophageal bleeding secondary to esophagitis or respiratory complication related to aspiration of gastric contents. Treatment for GERD and hiatal hernia in older adults is similar to that of younger adults. The increased use of laproscopic procedures has reduced surgical risks. Lifestyles changes may need to by implemented like eliminating caffeine-containing beverages and chocolate, elevating the head of...
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