Older age delayed gastric emptying and weakened LES tone Sleep apnea NG Tubeo

Older age delayed gastric emptying and weakened les

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Older age (delayed gastric emptying and weakened LES tone) Sleep apnea NG Tube o Review bowel assessment, constipation, diarrhea o Bowel assessment: Inspect → Auscultate → Percuss → Palpate o Constipation Monitor for Abdominal bloating Abdominal cramping Straining at defecation
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Presence of dry, hard feces at defecation. Irregular bowel movements, or reduced frequency from client’s normal pattern. hypoactive bowel sounds Nursing Care Increase fiber and water consumption (unless contraindicated) before more invasive interventions Give bulk-forming products before stool softeners, stimulants, or suppositories Enemas are last resort for stimulating defecation. o Diarrhea Monitor for Frequent loose stools Abdominal cramping Stool of water consistency hyperactive bowel sounds Nursing Care Help determine and treat the cause Administer medications to slow peristalsis Provide perineal care after each stool, and apply moisture barrier After diarrhea stops, suggest eating yogurt to help re- establish an intestinal balance of beneficial bacteria Review acid-base imbalances, signs/symptoms (see chart) o Normal Values pH = 7.35 - 7.45 PaCO2 = 35 - 45 HCO3 = 21- 28 o Respiratory Acidosis : HYPOventilation Results from: Brain tumors, cerebral aneurysm, stroke, or overhydration, trauma, or neurologic diseases Inadequate chest expansion due to muscle weakness, pneumothorax/ hemothorax, flail chest, obesity, sleep apnea, tumors, or deformities. Airway obstruction from neck edema, localized lymph node enlargement, foreign bodies or mucus Alveolar-capillary blockage secondary to a pulmonary embolus, thrombus, acute respiratory distress
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syndrome, chest trauma, drowning, or pulmonary edema Inadequate mechanical ventilation Results in Increase CO2 Decreased pH S&S Vitals: Tachycardia, tachypnea, increased blood pressure Dysrhythmias Anxiety, Irritability, confusion Ineffective shallow, rapid breathing Pale or cyanotic Seen in clients with COPD, pulmonary disease, sleep apnea, and obesity. o Respiratory Alkalosis: HYPERrventilation Results From: Hyperventilation due to fear, anxiety, intracerebral trauma, salicylate toxicity, or excessive mechanical ventilation Results in: Decreased CO2 Increased pH S&S Vitals: Tachypnea Inability to concentrate, numbness, tingling, tinnitus, and possible loss of consciousness Tachycardia, ventricular and atrial dysrhythmias Rapid, deep respirations o Metabolic Acidosis Results From: Excess production of hydrogen ions Diabetic Ketoacidosis (DKA) Lactic Acidosis Heavy exercise Seizure Activity Hypoxia Excess intake of acids Ethyl alcohol Methyl alcohol
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Acetylsalicylic acid (Aspirin) Inadequate elimination of hydrogen ions Kidney Failure Severe Lung problems Inadequate production of bicarbonate HCO3 Kidney Failure Pancreatitis Results in: Decreased HCO3 Decreased pH S&S: Dysrhythmias Vitals: Bradycardia, weak peripheral pulses, hypotension, tachypnea Headache, drowsiness, confusion
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