Exam 2- Upper GI Disorders Flashcards
(87 cards)
1
Q
Lip disorders
A
- Actinic cheilitis
- Herpes simplex 1- “cold sore”
- Chancre
2
Q
Mouth disorders
A
- Leukoplakia
Hairy leukoplakia - Lichen planus
- Candidiasis
- Stomatitis
3
Q
Gum disorders
A
- Gingivitis
- Periodontitis
4
Q
Periapical abscess
A
Root canal/abstraction
5
Q
Malocclusion
A
Incorrect placement of teeth with jaw closed
6
Q
Parotitis
A
7
Q
Sialadenitis
A
Inflammation of the salivary glands (common with radiation therapy and dehydration)
8
Q
Neoplasm
A
Potential for cancer
9
Q
Achalasia
A
Ineffective peristalsis (failure of the esophageal sphincter) to relax (for ppl with this, their food doesn’t move through the upper GI like it should)
10
Q
Medications that cause dry mouth in elderly
A
- Anti-depressants
- Antihypertensives
- Anti-inflammatory
- Diuretic
11
Q
Poor dentation can exacerbate problems of aging such as…
A
- Decreased food intake
- Increased risk of infection
- Loss of appetite
- Social isolation
- Trauma to oral cavity
12
Q
Nursing management for upper GI
A
- Promotion of mouth care
- Ensure adequate food and fluid intake
- Support positive self image
- Support communication
- Minimize pain and discomfort
- Prevention of infection
- Education
13
Q
Impaired Oral Mucous Membranes- Nursing Interventions (9)
A
- Oral care
- Dental care prior to surgery or radiation therapy
- Frequent gentle brushing and flossing
- Pt education related to oral hygiene
- Encourage fluid intake
- Use of synthetic saliva (Oral Balance, saliva production stimulant - Salagen)
- Avoid hot or spicy foods
- Vicious Xylocaine or other pain meds
- Anti-fungal medications for candidiasis, antibiotics, or corticosteroids for infection or stomatitis, topical
14
Q
Anti-fungal medications
A
Nystatin
15
Q
Synthetic saliva example
A
Oral Balance
16
Q
Saliva production stimulant example
A
Salagen
17
Q
Oral Cancer risk factors
A
Tobacco use
HPV infection
Excessive use of alcohol
Previous history of head/neck cancer
18
Q
Oral cancer increased risk for what gender and what race?
A
Men, Caucasian
19
Q
5 year survival rate for oral cancer
A
66%
20
Q
Who is at a higher risk for oral cancer?
A
Smokers and drinkers
21
Q
Manifestations of oral cancer
A
- Painless mass or sore that does not heal
22
Q
When should you get an exam on a sore?
A
Is lesion is present for more than 2 weeks
23
Q
Later manifestations of oral cancer
A
- Tenderness
- Difficulty in chewing, swallowing, or speaking
- Coughing up blood-tinged sputum
- Enlarged cervical lymph nodes
24
Q
Assessment for oral cancer
A
- Examination of oral and cervical lymph nodes
- Health history
- Inspect and palpate the structures of the mouth and neck
25
Diagnostic for oral cancer
Biopsy on suspicious lesions
26
Prevention of oral cancer
HPV vaccination (children 11-21 for males and 26 for females)
27
Medical management of oral cancer
- Surgical resection
- Radiation therapy
- Chemotherapy
28
Nursing management of oral cancer
- Nutritional status assessment
(enteral feedings)
- Communication
- Airway management post-op
- Oral care
- Body image
29
Malignancy of head and neck is what percent of all cancers?
5%
30
Treatment of malignancy of head and neck
- Chemo
- Radiation
- Surgery
31
Biggest procedure for head and neck cancer
Radical neck dissection
32
Problems related to radical neck dissection
- Hemorrhage
- High epigastric pain
- Chyle fistula
- Nerve injury
33
Early signs of potential complications of a radical neck dissection
Tachycardia
Tachypnea
34
Late sign of a radical neck dissection
Hypotension
35
Biggest complication with hemorrhage
High epigastric pain
36
What do we do for high epigastric pain?
- Call for help immediately
- Apply pressure
37
What do we avoid and observe regarding complications of a radical neck dissection?
- Avoid valsalva maneuver
- Observe dressing for s/s
38
What is high epigastric pain a sign of?
Carotid artery rupture
39
What is a chyle fistula?
Leakage of lymphatic fluid
40
Nursing care: What do we do for airway following a neck dissection?
- Fowler's position
- C & DB
- Trach care
- Assess for stridor & s/s respiratory distress
41
Nursing care: Main actions following a neck dissection
- Assess airway
- Pain
- Bleeding
- Wound care
- Nutrition & communication
- Education, self esteem
- Physical mobility
42
How often do we do VS after neck dissection?
Q 15x4 x2 hours, then Q4 hours once stable
43
Wound care to assess/monitor after neck dissection
Drainage tubes
Dressing changes
44
What do nurses implement for physical mobility following neck dissection?
- Rehab exercises (done to promote maximum function after surgery)
- PT/OT consult
- Home or transitional care referral
45
Hiatal hernia
Opening in the diaphragm through which the esophagus passes, becomes enlarged, and part of the upper stomach tends to move up into the lower portion of the thorax
46
Hiatal hernia manifestations
- 50% are asymptomatic
- Heart burn
- Regurgitation
- Dyspepsia
47
Hiatal hernia management
- H2 receptor blockers
- Surgery to tighten cardiac sphincter
- Small, frequent meals
- Do NOT lie down for 1 hour after meals (elevate HOB)
48
What are the H2 receptor blockers used for a hiatal hernia?
Tagamet
Zantac
MOM
"Carafate"
49
Hiatal hernia nursing management
- Teaching
- Correct taking of meds
- Diet
- Lifestyle
50
Guidelines for diet with hiatal hernia
- Avoid spicy foods
- Avoid late night meals
- Avoid ETOH
- Frequent small meals
51
Hiatal hernia lifestyle is the same as...
GERD
52
Hiatal hernia lifestyle
- Do not recline for 1 hour after eating
- Elevate HOB on blocks 4-8 inches
53
Gastroesophageal reflux (GERD)
Occurs as a result of the backward flow (reflux) of gastrointestinal contents into the esophagus
54
Incidence of GERD increases with...
Age
(or if pt has a hiatal hernia)
55
GERD is associated with...
Barrett's Esophagus
56
GERD manifestations
- Pyrosis
- Dyspepsia
- Regurgitation
- Dysphagia
- Painful swallowing
57
Pyrosis
Burning sensation
58
Dyspepsia
Indigestion
59
Diagnostic findings for GERD
- Endoscopy or barium swallow
(12-36 hour ambulatory esophageal pH monitoring to evaluate degree of acid reflux (wireless capsule))
60
Management of GERD
Diet therapy
61
What do we avoid with GERD
Peppermint
ETOH
Caffeine
Beer
Milk
Soda
SMK
62
Education for GERD
- Lifestyle changes
- Avoid eating or drinking 2 hours before bed
- Weight management, HOB elevated
63
Medications for GERD
- Anatacids
- H2 blocker
- Proton pump inhibitor
- Prokinetic medications
64
H2 Blockers (histamine receptor antagonists) used for GERD
Pepcid
Zantac
Axid
Tagamet (interferes w other drugs and is short acting)
65
Proton pump inhibitors used for GERD
Prevacid
Prilosec
Protonix
Nexium
66
Prokinetic meds used for GERD
Reglan
67
Antacids for GERD
- Maalox
- MOM
- Sodium bicarbonate
- Tums
68
When should you take antacids for GERD?
Before and 2-3 hours after meals
69
Concerns with taking antacids for GERD
- Concern with altering acid-base balance if used excessively
- Concern with getting too much magnesium, sodium, or calcium
70
What do H2 blockers do for GERD?
Decrease acid production
71
Which H2 blocker interferes with other drugs and is short acting?
Tagamet
72
What meds are often used OTC for GERD?
Histamine receptor antagonists
73
Which meds are prescribed for GERD?
Proton pump inhibitors
74
Proton pump inhibitor action
Reduces gastric acid production for up to 24 hours
75
When should you take proton pump inhibitors for GERD?
Before meals or at bedtime
76
What meds are used with more severe GERD?
PPIs
77
Which type of med do we NOT crush when giving for GERD?
PPIs
78
What do prokinetics do?
Accelerate gastric emptying
79
Which meds are not used for long term use because they cause extrapyramidal (tremors, muscle contractions, seizures) s/s?
Prokinetics
80
Cancer of the esophagus may be caused by...
Chronic irritation
81
This diagnosis is typically advanced at diagnosis
Esophageal cancer
82
What increases risk for esophageal cancer?
Smoking and drinking
(even secondhand smoke)
83
Esophageal cancer and what, go hand in hand?
GERD
84
Most common complaint for esophageal cancer
Dysphagia
85
What confirms esophageal cancer diagnosis?
EGD
86
Esophageal cancer treatment
Resection versus palliative care
87
Usually, how long is life expectancy for esophageal cancer?
Less than 6 months because of late diagnosis
