Concepts of Adult Health
An elderly patient is exhibiting abdominal distention and chronic constipation.
Constipation occurs when bowel movements occur less frequently than usual. Even though it is common among patients, constipation can become a significant problem. In the case of the elderly, the patient should be advised to schedule toileting after meals. This is done to take advantage of the gastrocolic reflex. The patient should also be advised not to ignore the urge to have a bowel movement when it arises. Also, when going for a long call, the patient should ensure that he straightens the anorectal junction. This can be done by placing their feet on a small step stool instead of directly on the floor to straighten the anorectal intersection. The patient should be given lifestyle education, including exercise, avoiding the use of bedpans to defecate, and advice on increasing fiber and fluid intake. Exercise improves the transit of waste. Do you need urgent assignment help ? Our homework help will you tons of energy and time required for your homework papers.
The patient should be advised to take additional fiber intake in their diet. Fiber intake should be increased slowly over several weeks. This is done to decrease the adverse effects that may arise, such as abdominal cramping, flatulence, and bloating. The patient can also use supplements like psyllium, methylcellulose, or polycarbophil (Kurniawan et al.,2020). Fiber increases the bulk of stool and facilitates food movement through the intestines. This improves the symptoms. The recommended daily fiber intake is 20-35 g per day. The patient should also be advised to increase fluid intake. Daily water requirements are 1.5-2 L per day. When combined with a high-fiber diet, this has been shown to improve stool frequency.
Several factors are known to predispose one to develop constipation. Some of the risk factors responsible are a sedentary lifestyle, lack of activity, low-fiber diet, limited fluid intake, certain medications such as opioids, laxative overuse, lack of privacy, stress, ignoring the urge to defecate, depression, fear of pain with defecation, a tumor, and neurogenic disorders (Kurniawan et al.,2020).
Compare and contrast the etiology and management of acute vs chronic gastritis.
Gastritis is classified as either acute or chronic based on the time course of the disease. Acute gastritis usually becomes chronic if not treated (Azer & Akhondi, 2020). The etiology is different for both acute and chronic gastritis. Acute gastritis is generally due to infection or an irritant. The causes of acute gastritis include drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), potent alcoholic beverages such as vodka, bacterial infections such as H. pylori, viral infections such as CMV, parasitic infections such as anisakiasis, fungal infections such as candidiasis, acute stress, radiation, food poisoning, bile reflux, ischemia of the stomach, and direct trauma. H. pylori-associated gastritis is the most common cause of gastritis.
Chronic gastritis is usually due to long-term damage to the stomach lining. Chronic gastritis usually appears as non-atrophic or atrophic and results from H. pylori. The progression of gastritis from acute to regular condition usually begins in childhood and progresses in years or decades. It starts as a superficial mononuclear inflammation of the gastric mucosa. Chronic gastritis can also result from autoimmune gastritis, a chronic inflammatory disease (Lenti et al., 2020).
A 45-year-old patient is receiving parenteral nutrition through a subclavian triple-lumen catheter. What are the indications for parenteral nutrition?
Total parenteral nutrition (TPN) is the IV nutrition administration to a patient outside the gastrointestinal tract. TPN is usually indicated for patients with chronic intestinal obstruction, as in the case of intestinal cancer (Liu et al., 2020). It can also be prescribed when a patient has bowel pseudo-obstruction or food intolerance. Patients with small bowel obstruction can also feed using TPN. Severe diarrhea and vomiting are also indications since such patients usually cannot maintain nutritional status. Patients who undergo bowel surgery and develop anastomotic leaks are also kept on TPN.
References
Azer, S. A., & Akhondi, H. (2020). Gastritis. StatPearls [Internet].
Kurniawan, A. H., Kholili, U., & Widajanti, N. (2020). Constipation in Elderly Population and Its Appropriate Management. The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy, 21(3), 212-219.
Lenti, M. V., Rugge, M., Lahner, E., Miceli, E., Toh, B. H., Genta, R. M., … & Di Sabatino, A. (2020). Autoimmune gastritis. Nature Reviews Disease Primers, 6(1), 1-19.
Liu, M., Laskaratos, F. M., Bennell, J., Chen, J., Toumpanakis, C., Mandair, D., & Caplin, M. (2020). Home Total Parenteral Nutrition for Intestinal Failure in Patients with Advanced Small Intestinal Neuroendocrine Neoplasms. Nutrition and Cancer, 1-6.
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Question 
1. An elderly patient is exhibiting abdominal distention and chronic constipation.
Concepts of Adult Health
- a. What instructions would be essential for this patient concerning recurring constipation?
- b. What are the risk factors contributing to constipation in the elderly population?
2. Compare and contrast the etiology and management of acute vs chronic gastritis.
3. A 45-year-old patient receives parenteral nutrition through a subclavian triple-lumen catheter. What are the indications for parenteral nutrition?