Geriatric GI and GU Changes

GI

GI changes result from:
Relaxed lower esophageal sphincter delays emptying so meal size decreases
Decreased peristalsis, impaired absorption, decreased fluids = constipation
Hiatal hernia
Hunger sensations decrease
Pepsin and hydrochloric acid decrease
Calcium absorption decreases
B1 and B2 absorption decreases
Diverticulosis in 1/3 over 60
Decreased liver enzymes = less detoxification and drug metabolism

Oral changes - missing teeth, gums, decreased taste, dry mouth, decreased glucose and fat tolerance

Nursing Diagnoses:
Constipation
Deficient or imbalanced fluid volume
Imbalanced nutrition
Impaired mucous membrane

Nursing Interventions:
Good oral hygiene
Denture fit
Assess GI functioning
Increase fiber
Adequate hydration
Regular exercise
Small frequent meals
Discourage laxatives
Document bowel movements
Spices instead of sodium

GU:
Kidney

Nursing diagnosis:
Impaired urinary elimination
Disturbed personal identity
Sexual dysfunction

Interventions:
Observe for S&S of dehydration
2-3 liters of fluid intake a day
Complete antibiotics
*Filtering glomeruli decrease by 50%, therefore some medications take longer to clear the system, pcn, digoxin

Bladder:**
Bladder capacity decreases
Emptying becomes more difficult
Enlarged prostate = Increased frequency, dribbling, urinary retention and UTI's
Women stress incontinence

Nursing Interventions:

Bladder training
Void at first urge
Skin care if incontinent
Kegel exercises
Avoid sleeping pills
Avoid caffeine

References:

Potter, P. A., & Perry, A. G. (2009). Fundamentals of Nursing (7th ed.). St. Louis, Missouri: Mosby Elsevier.