CHEO PROJECT

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OBJECTIVES

Spell and define terms

Describe aging changes of gastrointestinal system

Describe some common disorders of gastrointestinal system

Describe NA actions related to care of patients with disorders of gastrointestinal system

List signs and symptoms NA should observe and report

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INTRODUCTION• Digestive tract extends from mouth to anus

• Receives help from teeth, tongue, salivary glands, liver, gallbladder, and pancreas in breaking down food into simpler substances

• Substances are used by body cells to carry on work of supplying nutrition and eliminating wastes

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DIGESTIVE CHANGES WITH AGE

Colon slows down, causing: Food to remain in stomach longer Slower food absorption Slower elimination

Taste buds lost

Saliva production decreases

Gag reflex less effective

Fewer digestive enzymes Resulting in indigestion and slower absorption of fat

Constipation

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COMMON DIGESTIVE DISORDERS

Ulcers

Ulcerative colitis

Gastroesophageal reflux disease (GERD)

Hernias

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COMMON CONDITIONS

Cholecystitis

Cholelithiasis

Constipation

Fecal impaction

Diarrhea

Diverticulitis

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COMMON PROBLEMS RELATED TO THE LOWER BOWEL

Frequency of bowel elimination varies among individuals

Some people have more than one bowel movement (BM) a day Others have BM every two or three days

BM usually soft and formed

If BM passes through colon too quickly, loose and watery in consistency

Diarrhea Multiple watery stools

If BM passes through colon too slowly, hard, dry, or sticky and pasty in consistency

Constipation

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COMMON PROBLEMS RELATED TO THE LOWER BOWEL

Fecal material normally brown Color can be affected by certain foods, medications, and diseases

Abdominal distention Occurs when abdomen enlarges and appears bloated Usually occurs as result of flatus (gas) Are other causes

Fecal impaction Most serious form of constipation Caused by retention of stool in rectum where water is absorbed

Rectal prolapse Large portion of rectum protrudes from body

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COMMON PROBLEMS RELATED TO THE LOWER BOWEL

Over time, stool becomes hard and dry Patient cannot pass it

Dried waste irritates bowel

Mucus dissolves hard, outer part of mass

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NURSE AIDE RESPONSIBILITIES WITH BOWEL CARE

Monitor bowel elimination and report irregularities

Record bowel movements on flow sheet

If the patient is independent with bowel elimination, ask if had BM each day

Report the following to nurse: Frequent stools Absence of stools Pain Cramping Excessive flatulence

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NURSE AIDE RESPONSIBILITIES WITH BOWEL CARE

Report the following to nurse: Abnormal color or consistency of stool Extremely small amounts of stool Hard, dry stool Enlargement of abdomen

Save abnormal stools for nurse to assess

Report the following stool abnormalities:

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NURSE AIDE RESPONSIBILITIES WITH BOWEL CAREReport the following stool abnormalities: Blood Pus Mucus Black or other unusual color Undigested food

Except corn and raisins Presence of parasites

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ENEMAS

Cleansing enema Introduces fluid into rectum to remove feces and flatus from colon and

rectum

Avoid giving enema within an hour after meals Increases peristalsis

Making it difficult for the patient to retain solution

Avoid administering enema to the patient in sitting position. Solution will not flow into colon

Causes rectum to enlarge Causing rapid expulsion of fluid

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RECTAL TUBE AND FLATUS BAG

Used to enable gas in bowel to escape Use once every 24 hours for 20 minutes

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OSTOMIES

Ostomy Surgical removal of a section of diseased bowel

Creates artificial opening in abdominal wall for elimination of solid waste and flatus

Appliance contains waste products Skin irritation is great risk