Oral and Esophageal Disorders Flashcards
(40 cards)
1
Q
Temporomandibular Joint Disorder (TMJ) S/S
A
- pain w/ chewing
- jaw pain (morning)
- jaw joint popping/clicking
- limited opening/ROM
- worn, cracked, chipped teeth
- loose, sore teeth
- unstable tooth position
- headaches
- sinus pressure
- neck/shoulder tension
- sense of water in ears
2
Q
Non-Surgical Treatment for TMJ
A
- stress management
- mouth guards for nights
- ROM exercises
- pain meds
3
Q
Surgical Treatment for TMJ Fractures
A
- insertion of metal plates and screws for stabilization
- wiring of jaw shut for several weeks
- may be stabilized using rubber bands
4
Q
What are the 2 most common causes for TMJ?
A
Osteoarthritis or Dislocation of jaw
5
Q
TMJ Nursing Management Post-OP
A
- liquid/pureed diet
- no chewing up to 4 weeks
- keep wire cutters/scissors at bedside
- may need straw
- keep mouth clean-soft sponge or child sized tooth brush
- report any ulcerations to provider
6
Q
Parotitis
A
inflammation of parotid gland
7
Q
Risk factors for Parotitis
A
- decreased salivary flow
- dehydration
- meds
- infections (mumps, flu, staph)
8
Q
Parotitis S/S
A
- primary condition
- swollen, hardened, tender glands
- ear pain
- difficulty swallowing
9
Q
Nursing Management for Parotitis
A
- assist w/ adequate oral/dietary intake
- oral hygiene
- hold/DC meds r/t problems
- antibiotics/pain meds
- I&D
10
Q
S/S for Oral cancers
A
- asymptomatic until late stages
- painless sore that is difficult to or will not heal
- indurated (hard) w/ raised edges
11
Q
Treatment for Oral Cancers
A
- radiation therapy
- chemotherapy
- surgery
12
Q
Radical Neck Dissection
A
all tissue on side of neck from jawbone to collar bone is removed
all muscle, nerve, salivary gland, and major blood vessel is removed
13
Q
Modified Radical Neck Dissection
A
- MOST COMMOM
- all lymph nodes are removed
- less neck tissue taken
- may spare nerves and sometimes blood vessels or muscle
14
Q
Selective Neck Dissection
A
if cancer has not spread far, fewer lymph nodes are removed
muscle, nerve, and blood vessel may be saved
15
Q
Laryngectomy
A
permanent laryngeal stoma
16
Q
Concerns for Laryngectomy
A
- airway
- communication
- nutrition
- body image
17
Q
Nursing Management for Laryngectomy
A
- dietary consult
- assess swallowing
- suctioning
- monitor graft site
- assess for excessive dry mouth
- assess for stomatitis
- dentistry may be needed
- assess support system
18
Q
Airway Considerations
A
- semi-fowlers position
- assess for respiratory distress
- auscultate lung sounds (stridor=call provider ASAP)
- coughing/deep breathing
- suction prn
- assess swallowing
- consult speech patho
19
Q
Wound Care
A
- JP drain may remain for 3-5 days
- drainage should decrease after 1st 24 hrs
- reinforce dressing but do not remove
- assess graft
- assess for swelling
- assess for infection
20
Q
Nutrition
A
- assessment begins pre-operatively
- enteral/parenteral feedings
- diet modifications based on chewing/swallowing
- oral care
21
Q
Communication and Mobility
A
- pencil & paper
- white board
- communication board
- PT/OT after drains removed and incision healing
- early ambulation
22
Q
Monitor for Complications
A
- hemorrhage
- chyle fistula
- nerve damage
23
Q
Chyle Fistula
A
- assess for milky odorless discharge
- corrected through monitoring and diet or surgery
24
Q
Hiatal Hernia
A
part of stomach pushes upward through the opening in the diaphragm that the esophagus passes through
25
S/S of Hiatal Hernia
- asymptomatic
- heartburn/chest pain
- dysphagia
- regurgitation
- incarceration (strangulation) w/ obstruction
- sudden severe pain
- n/v
26
Management for Hiatal Hernia
- frequent small meals
- sit up for 1 hr after meals
- keep HOB elevated while sleeping
- antacids
- H2 antagonist
- PPIs
- surgery
27
Diverticulum
abnormal sac/pouch that forms at weak point on the esophagus
28
Diverticulum S/S
- dysphagia
- chronic bleeding
- regurgitation
- chronic bad breath
- chest pain
29
Management for Diverticulum
- surgery
- NPO until after non-leakage verified
- CL advance as tolerated
30
Causes of Esophageal Perforations
- surgery
- trauma
- severe retching/vomiting
31
S/S of Esophageal Perforations
- persistent pain
- dysphagia
- trouble speaking/breathing
- fever/leukocytosis
- hypotension
32
Management for Esophageal Perforations
- broad spectrum antibiotics
- minor wound symptoms: NPO, enteral, parenteral feedings up to 1 month or more, barium swallows, clear liquids
- surgery
33
Barium Swallow
- patient drinks a preparation containing the solution and an x-ray is used to track its path through GI tract
- 30-60 mins to complete
- increase fluid and fiber intake to prevent constipation
34
Gastroesophageal Reflux (GERD)
gastric and/or duodenal contents backflow into esophagus
35
GERD may result from what?
- obesity
- weak lower esophageal sphincter
- pyloric stenosis
- motility disorder
36
S/S of GERD
- dyspepsia (indigestion)
- regurgitation
- dysphagia
- odynophagia
- excessive salivation
- patient believes they are having MI
- Barret's Esophagus
37
What is Barret's Esophagus?
normal tissue lining in the esophagus changes to tissue that resembles the lining of the intestines
38
Barret's Esophagus increases your risk for developing what?
esophageal adenocarcinoma
39
S/S of Barret's Esophagus
- narrowing of esophagus caused by inflammation and scar tissue
- difficulty swallowing
- coughing when eating or drinking
- full feeling in throat
- frequent belching
- treatment w/ esophageal dilation
40
Management of GERD/Barret's Esophagus
- low fat diet
- avoid caffeine, alcohol, tobacco, milk, carbonated drinks
- stop eating at least 1 hr before bed
- sit up for 1 hr after eating
- sleep with HOB elevated
- meds: antacids, gastric emptying accelerators
