Chapter 53 Flashcards
(31 cards)
PASS If this dysphagia is suspected
Probable that the patient will have swallowing difficulty
account for the previous one problems
screen for signs and symptoms
speech language pathologist referral
Signs and symptoms of dysphagia to be alert for if the patient has stomatitis
Coughing or choking when swallowing
sensation of the food sticking in the pharynx
difficulty initiating the swallow process
What to teach patients when using for viscous lidocaine/ magic mouthwash
Use extreme caution because it’s anesthetizing in effect may cause burns from hot liquids in the mouth and or increase the risk of choking
What is stomatitis?
Inflammation within the oral cavity it may present as painful single or multiple ulcerations, called apthous or canker sores.
Inflammation and erosion of the protective lining of the mouth is one of the most common forms
What is primary Somatitis
The most common type includes aPHTHOUS somatitis herpes simplex sOmatitis and traumatic ulcers these are non-infectious.
What is secondary stomatitis?
result from opportunistic virus fungi or bacteria in patients with that compromise immune system or drug such as chemotherapy
What is a common type of stomatitis
Candida which is present in mouth in small amounts especially older adults
Some causes of Candida
long-term antibiotic therapy
immunosuppressive therapy:chemotherapy radiation or steroids
Infection allergy
vitamin deficiency;vitamin B or iron folate zinc
systematic disease o
irritatants: such as tobacco and alcohol
hyperactivity of the immune system
What foods can trigger allergic responses to cause apthous ulcers
Coffee potatoes cheese nuts fruits and gluten
Assessment for stomatitis
History of recent infections nutrition changes
hygiene habits or trauma stress drug history including OTC
nutrition and herbal supplements
course of outbreaks
If lesions interfere swallowing eating or communicating
What is Oral candidiasis?
White plaquelike lesions appear on the tongue palette pharynx cheek when there are wiped away the tongue is red and sore
patients report alterations in comfort or dry hot lesion
down the esophagus patient may have difficulty swallowing/dysphasia
throat pain
What to document when assessing the mouth
characteristics of the lesions including the location, size, shape, odor, color and drainage.
coating or cracking
difficulty swallowing
Patient at risk for candidasis
Older adults due to decreased immune function
Diabetes malnourished
emotional stress
multiple medications that contribute to or dryness and decrease salvation
Dentures
older adults with poor oral hygiene
Older intubated patients in critical care settings
Interventions for stomatitis To preserve tissue integrity
Remove the dentures
oral hygiene after each meal or more frequent
Mouth care every two hours or more frequently
Soft toothbrush/gauge
Rinse with warm Saline or sodium bicarbonate or combination
avoid mouthwash with alcohol and lemon
Select soft bland no acidic foods
apply tropical analgesics or anesthetics
Interventions to minimize alterations and comfort with Stomatitis
hot or cold liquids can be soothing
Avoid Hard spicy salty acidic foods
Chose foods high in protein and vitamin C such a scramble eggs bananas custards pudding and ice cream
over-the-counter medication such as a benzocaine anesthetic: orabase
lidocaine may also be prescribed as a gargle or mouthwash
Leukoplakia
Slowly develop remember it’s causing thickening and white firmly attached patches they cannot easily be scraped off they are slightly raise and Sharply round which are benign
Leukoplakia risk factors
Poor fitting dentures chronic cheek nibbling , Broken teeth HIV infection Or Epstein bar virus tobacco People over 40 years old higher in men than women
Erythroplakia
Read a velvety Makossa lesions on the surface of the oral Macosa these are malignant or pre-cancerous and a biopsy should be performed most commonly found on the floor of the mouth tongue palate and mandibular mucosa
Prevention strategies for oral cancer
Minimize sun exposure
tobacco cessation
decrease alcohol intake
reduce exposure radiation from x-rays
Major risk factors for oral cancer
Increasing in age older than 40 years old
alcohol use
tobacco use
Highest risk the person using alcohol and tobacco together
Textile workers plumbers coal metal workers
periodontal gum disease
sun exposure
poor nutrition poor oral hygiene infection of HPV 16
Kaposi’s sarcoma
a malignant lesion and blood vessels appear as raise purple/ reddish Nigel or plaque usually painless is found in the hard palate and his
most common site also can be found in the gums and tongue or the tonsils it it also is often associated with aids
Nursing intervention for oral cancer treatment
Maintain an open airway is priority of care to promote gas exchange
Second is the focus on restoring and maintaining oral health
Non-surgical interventions for oral cancer
Increase gas change removing secretions prevent aspiration
Asses RR for quality rate and depth. Stridor is obstruction
promote deep breathing exercises and effective coughing mobilize secretions
To promote gas exchange place the patient in semi flowers or high flowers encourage fluids if gas reflexes intact chest physiotherapy increases exchange and promotes effective coffee collaborate with the respiratory therapist use oral suction equipment
Genetic considerations
Genetic variations in patients with orange cats are having fun especially in imitation of the TP53 is nicknamed the guardian of the genome because two more protein P 53 is essential for cell division regulation and prevention of tumor formation always ask family history of any type of cancer oh yeah a session patience for organic
