Care of Gastrointestinal Problems in the Older Adult (Springer Series on Geriatric Nursing)

265 Pages·2004·1.29 MB·English

by  Sue E. Meiner BC GNP EdD APRN

Springer Series on Geriatric Nursing
Mathy D. Mezey, RN, EdD, FAAN, Series Editor
New York University Division of Nursing
Advisory Board: Margaret Dimond, PhD, RN, FAAN; Steven H. Ferris, PhD;
TerryFulmer,RN,PhD,FAAN;LindaKaeser,PhD,RN,ACSW,FAAN;Virgene
Kayser-Jones,PhD,RN,FAAN;EugeniaSiegler,MD;NevilleE.Strumpf,PhD,
RN, FAAN; May Wykle, PhD, RN, FAAN; Mary K. Walker, PhD, RN, FAAN
2004 CareofGastrointestinalProblemsintheOlderAdult
SueE.Meiner,EdD,APRN,BC,GNP
2003 GeriatricNursingProtocolsforBestPractice,2nded.
MathyD.Mezey,EdD,RN,FAAN,TerryFulmer,PhD,RN,FAAN,IvoAbraham,
PhD,RN,FAAN,DeArneZucker,ManagingEditor,MA,APRN,BC
2002 CareofArthritisintheOlderAdult
AnnSchmidtLuggen,PhD,RN,MSN,CS,BC-ARNP,and
SueE.Meiner,EdD,APRN,BC,GNP
2002 ProstateCancer:NursingAssessment,Management,andCare
MeredithWallace,PhD,RN,CS-ANP,andLorrieL.Powel,PhD,RN
2002 BathingWithoutaBattle:PersonalCareofIndividualsWithDementia
AnnLouiseBarrick,PhD,JoanneRader,RN,MN,FAAN,BeverlyHoeffer,DNSt,
RN,FAAN,andPhilipD.Sloane,MD,MPH
2001 CriticalCareNursingoftheElderly,SecondEdition
Terry Fulmer, PhD, RN, FAAN, Marquis D. Foreman, PhD, RN, FAAN, Mary
Walker,PhD,RN,FAAN,andKristenS.Montgomery,PhD,RNC,IBCLC
1999 Geriatric Nursing Protocols for Best Practice
Ivo Abraham, PhD, RN, FAAN, Melissa M. Bottrell, MPH, Terry T.
Fulmer, PhD, RN, FAAN, and Mathy D. Mezey, EdD, RN, FAAN
1998 HomeCareforOlderAdults:AGuideforFamiliesandOtherCare-
givers—Text and Instructor’s Manual/Lesson Plan
Mary Ann Rosswurm, EdD, RN, CS, FAAN
1998 Restraint-Free Care: Individualized Approaches for Frail Elders
NevilleE.Strumpf,PhD,RN,C,FAAN,JoannePattersonRobinson,PhD,
RN, Joan Stockman Wagner, MSN, CRNP, and Lois K. Evans, DNSc,
RN, FAAN
1996 Gerontology Review Guide for Nurses
ElizabethChapmanShaid,RN,MSN,CRNP,andKayHuber,DEd,RN,
CRNP
1995 Strengthening Geriatric Nursing Education
Terry T. Fulmer, RN, PhD, FAAN, and Marianne Matzo, PhD, RN, CS
1994 Nurse-Physician Collaboration: Care of Adults and the Elderly
Eugenia L. Siegler, MD, and Fay W. Whitney, PhD, RN, FAAN
1993 Health Assessment of the Older Individual, Second Edition
Mathy Doval Mezey, RN, EdD, FAAN, Shirlee Ann Stokes, RN, EdD,
FAAN, and Louise Hartnett Rauckhorst, RNC, ANP, EdD
1992 Critical Care Nursing of the Elderly
TerryT.Fulmer,RN,PhD,FAAN,andMaryK.Walker,PhD,RN,FAAN
This page intentionally left blank
C
are
of
Gastrointestinal
Problems
in
Older Adult
the
Sue E. Meiner,
EdD, APRN, BC, GNP
Editor
SPRINGER PUBLISHING COMPANY
Copyright©2004bySpringerPublishingCompany,Inc.
Allrightsreserved
Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmit-
tedinanyformorbyanymeans,electronic,mechanical,photocopying,recording,or
otherwise,withoutthepriorpermissionofSpringerPublishingCompany,Inc.
SpringerPublishingCompany,Inc.
536Broadway
NewYork,NY10012-3955
AcquisitionsEditor:RuthChasek
ProductionEditor:JaniceStangel
CoverdesignbyJoanneHonigman
0405060708/54321
LibraryofCongressCataloging-in-PublicationData
Careofgastrointestinalproblemsintheolderadult/SueMeiner,editor.
p.;cm.—(Springerseriesongeriatricnursing)
Includesbibliographicalreferencesandindex.
ISBN0-8261-1865-8
1. Geriatric gastroenterology. 2. Geriatric nursing. [DNLM: 1. Gastrointestinal
Diseases—nursing—Aged. 2. Geriatric Nursing—methods. WY 156.5 C271 2004]
I.Meiner,Sue.II.Series.
RC802.4.A34C372004
618.97'633—dc22 2004004159
PrintedintheUnitedStatesofAmericabyIntegratedBookTechnology
Contents
Contributors ix
Preface xi
1. Introduction and Demographic Data 1
Sue E. Meiner
2. General Disorders of the Upper Gastrointestinal System 7
Beverly Anderson Reno
3. Gastroesophageal Reflux Disease 23
Catherine Hill
4. Motor Dysfunctions of the Stomach 47
Susan D. Kowalski
5. Helicobacter Pylori and Ulcers 59
Phyllis J. Atkinson
6. Bacterial, Viral, and Parasitic Infections of the Colon 67
Sue E. Meiner
7. Vitamin B and Folate Deficiencies 81
12
Lori Candela
8. Cancers of the Gastrointestinal Tract 95
Ann Schmidt Luggen
9. Nutrition and Gastrointestinal Diseases 129
Barbara Resnick
10. Irritable Bowel Syndrome 157
Sue E. Meiner
11. Diverticular Disease 177
D. Sue Clarren
12. Constipation and Noninfectious Diarrhea 201
Lynn Ferebee and Sue E. Meiner
13. Hemorrhoids and Problems of the Anus and Rectum 215
Catherine Hill
Index 245
vii
Idedicatethisbooktomyfamily,friends,andcaringprofessionals
in the fields of nursing, nursing education, and advanced practice
nursing. I extend a very special thanks to Ruth Chasek, Nursing
EditorwithSpringerPublishingCompany,forherhoursofsupport
during the high, and sometimes low, road of writing and finishing
a manuscript. And finally, in God I trust.
Contributors
Phyllis Atkinson, MSN, RN, CS, Susan Kowalski, PhD, MSN, RN
GN Associate Professor
St. Elizabeth Medical Center School of Nursing
Family Practice Center University of Nevada, Las Vegas
Edgewood, Kentucky
Ann Schmidt Luggen, PhD, MSN,
Lori Candela, EdD, MSN, RN APRN, GNP
Interim Associate Director Professor of Nursing
School of Nursing Northern Kentucky University
University of Nevada, Las Vegas Highland Heights, Kentucky
Donna Sue Clarren, ND, MSN, Beverly Reno, MSN, RNC
RN Associate Professor of Nursing
Assistant Professor Northern Kentucky University
School of Nursing Highland Heights, Kentucky
University of Nevada, Las Vegas
Barbara Resnick, PhD, CRNP,
Lynn Ferebee, MSN, RN, FNP FAAN, FAANP
Family Nurse Practitioner Associate Professor
Student Health Center University of Maryland School of
University of Nevada, Las Vegas Nursing
Las Vegas, Nevada Baltimore, Maryland
Catherine Hill, MSN, RN, CS,
ONC, CEN
Medicine Associates of North Texas
School of Nursing
University of Texas at Arlington
ix
SueE.Meiner,EdD,APRN,BC,GNP,isan
AssistantProfessorintheSchoolofNursing
at the University of Nevada, Las Vegas, and
a Gerontological Nurse Practitioner with
HealthEssentials Home Care in Las Vegas.
She received her BSN and MSN degrees at
St. Louis University (Missouri), her EdD at
SouthernIllinoisUniversityatEdwardsville,
and her GNP from Jewish Hospital College
ofNursingandAlliedHealthatWashington
UniversityMedicalCenterinSt.Louis,Mis-
souri. She holds two national certifications from the American Nurses
Credentialing Center. Dr. Meiner is certified as a Gerontological Clinical
Nurse Specialist and as a Gerontological Nurse Practitioner. Prior to her
current position, she was Project Director for an NIH and NIA grant at
Washington University School of Medicine (St. Louis). Dr. Meiner has
authored the book, Nursing Documentation: Legal Focus Across Practice
Settings.Sheisco-authorofseveralotherbooks,includingCareofArthritis
in the Older Adult, NGNA Core Curricula for both gerontological nurses
and gerontological advanced practice nurses, and Handbook for the Care
of Older Adults with Cancer. She is also the author of numerous book
chaptersandjournalarticles.Dr.Meinerheldanelectedpoliticalofficein
St.LouisCountyforfiveyearsinthe1980sandremainsactiveincommu-
nity service. For over 15 years, she has served nationally as an expert
witness on nursing standards of care.
Preface
Asagerontologicalnursepractitioner,Iseemanyolderadultswithgastro-
intestinal disorders that have been troubling them for decades. Even my
personal experience with family and friends has brought home the preva-
lence of gastrointestinal problems in older adulthood.
This book was developed to provide greater information on a variety
of gastrointestinal disorders and problems than can be found in general
nursingtextbooks.Whiletheinformationinthisbookrangesfromgeneral
toscientific,itisintendedforusebyawidevarietyofnursingprofessionals
from hospital nurses, to home care nurses, to nurse practitioners. Each
clinician should choose the aspects of the text that are relevant to his or
herpractice.However,theoverallcontentwilladdmorespecificknowledge
to caring for the most common gastrointestinal problems of older adults.
Most of the chapters follow a pattern that includes discussion of a
specific gastrointestinal problem followed by its cause, noted normal and
abnormal physiology, nursing care with attention to nursing diagnoses,
interventions, medications, and alternative therapies, where appropriate.
Topics such as health promotion and quality of life issues were added as
an essential part of any plan of care for older adults. Home management
and self-care issues are addressed.
Ihopethatyouwilllearnmuchfromthisbookandwillusetheinforma-
tion to make the life of the older adults you care for more comfortable
during their remaining life.
Sue E. Meiner, EdD, APRN, BC, GNP
xi