Ch.46 Bowel Elimination Flashcards
(31 cards)
Esophagus
Reduced motility lower third portion
Causes
Degeneration of neural cells
table 46-1 normal age related changes in the GI tract
-CHANGES THAT OCCUR IN OLDER ADULTS
Mouth
Decreased chewing and salivation
Oral dryness
What causes this
Degeneration of cells and medications
Stomach
Decreased in acid secretions
Motor activity
Mucosal thickness
Causes:
Degeneration of gastric mucosa
Leads to malabsorption of iron
Delayed gastric emptying
Individual doesn’t feel hungry
Loss of parietal cells
Leads to intrinsic factor -> necessary for vitamin B12 absorption
Small intestine
Decreased nutrient absorption
Causes
Less absorbing cells
Large intestine
Small holes / pouches form on Weak intestinal wall
Causes
Weak musculature
Constipation
Causes :decreased peristalsis
Risk for fecal impaction
Duller nerve sensations
Liver
Size is decreased
Causes:
Reduced storage capacity and ability to synthesize protein and metabolized medications
Table 46–2 medications and the gastrointestinal system
what actions do certain medications have on the G.I. system
Bentyl -dicyclomine HCL
It slower peristalsis and gastric emptying
Opioids analgesics
Slows peristalsis and contractions which causes constipation
Anticholinergic drugs :atropine , glycopyrrolate (robinul)
Inhibits gastric secretions
Slows GI motility
Causes constipation
NSAIDS
causes GI irritation causing bleeding
Rectal bleeding
Aspirin
Prostaglandin inhibitor
Interferes with the normal mucosal lining of the stomach
Causes bleeding
Histamines antagonist
Decreases HCL sections
Interferes with food digestion
Iron Change in stool-blck Nausea Vomiting Constipation Abdominal cramps
Why does constipation occur?
BOX 46-1
Irregular bowel habits and ignoring the feeling of defecation Chronic illnesses: multiple sclerosis chronic bowel diseases depression eating disorders Low fiber diet No fluid intake slows peristalsi depression cognitive impairment laxative miss use slow peristalsis abdominal muscle elasticity reduced intestinal mucus secretion neurological conditions to blog nerve impulses to the Colon- spinal cord injury ,tumor hypothyroidism hypocalcemia hypokalemia diuretics Anti depressants ,convulsants histamines ,hypertensives
Table 46–3 laboratory and diagnostic test for function
Total BiliRubin 0.3 – 1 mg/dL If increased there are abnormalities such as: Hepatobiliary diseases Obstruction in bile duct Anemias Transfusion reactions
Alkaline phosphatase
30-120 units/L
Elevated in hepatobiliary diseases
Carcinomas
Bone tumors
Healing fractures
Amylase:
60-120somogyi units/dL
Pancreas abnormalities Inflammation Tumors Cholecystitis :gallbladder inflammation Necrotic bowel DKA
Endoscope - colonoscopy
Recommended for individuals after 50years old
X-ray film with contrast medium
Identifies abnormalities in the G.I. tract indirect visualization of the entire GI track
series of x-ray films and it defies any
tumors
ULCERATIONS
INFLAMMATION
indicating further diagnostic testing our medical surgical intervention
Table 46–4 fecal characteristics
how are the characteristics of normal stool
Color
infant is yellow
adult brown
White : absence of bile Black : iron ingestion or GI bleeding Red: lower GI bleeding ,hemorrhoids Pale with fat: malabsorption of fat Translucent mucus : colitis ,spastic constipation excessive straining Bloody mucous: inflammation , infection
Odor
Pungent affected by food type
Abnormal
Noxious change
Cause
Blood in feces or infection
Consistency
Soft , formed
Abnormal
Liquid : diarrhea , reduced absorption
Hard : constipation
Frequency
Varies
Infant 4-6 times a day breast fed
1-3 times daily bottled fed
2-3 times a week adult
Amount
150 g/day adult
Abnormality
Hypo motility or hypermotility
Shape
Resembles diameter of rectum
Abnormal
Narrow pencil shaped
Cause
Rapid peristalsis
Obstruction
Constituents
Un digested food Dead bacteria Fat Bile pigment Cells lining Intestinal mucosa Water
Abnormal: blood Pus Foreign bodies Mucus Worms Causes: internal bleeding , infection, swallowed objects, Irritations , inflammation
Excessive fat-malabsorption ,enteritis , pancreatic disease , surgical resection of intestine
Who Must be screened for colon cancer
Over 50 years of age family history of colon cancer Jews of eastern European descent African-Americans high intake of animal fats and not enough intake of vegetables ,Fruits obesity and inactivity smoking and alcohol intake diabetes
Considerations for testing
Fecal occult blood test
IFOBT fecal immunochemical
EVERY YEAR
IFOBT or gfobt
Every year plus flexible sigmoidoscopy very 5 years
Double contrast barium enema very 5 years
Colonoscopy every 10 years
Table 46–5 common types of laxative and cathartics
Bulk forming
Methyl cellulose - citrucel
Psyllium- Metamucil ,naturacil
Polycarbophil-fibercon
What does it do? High fiber contents absorb water and increase solid intestinal bulk Stretch intestinal wall to stimulate peristalsis Why is it used ? Irritates less Most natural Safest Used for chronic constipation Relieve mild diarrhea
What are the risks?
May cause obstruction if powdered agent not mixed well
May can contain stimulants
Patient who are in fluid restrictions must not take
Must take each dose with 8ounces of water
Emollient or wetting
Docusate sodium- Colace
D. Calcium-surfak
D. Potassium - dialose
What does it do?
Lowers surface tensions of feces-stool softener
Allows water to be absorb by feces so it can move through the intestines Colon easier
Why are they used?
Relieves straining
Risks?
Do not work well for chronic constipation
