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Chapter 42

from the powerpoint in D2L

Six predisposing factors for oral cancer 1) tobacco use 2) excessive alcohol intake 3) diet low in fruits/vegetables 4) chronic irritation 5) constant overexposure to sun 6) recurrent herpectic lesions
What are some s/s of oral cancer? nonhealing sores, bleeding sores, persistent patches in mouth, hard raised lesions, lumps, crusts, eroded areas, unexplained bleeding, persistent pain, difficulty chewing, swallowing, speaking or moving tongue
s/s of GERD heartburn, chest pain, sore throat, hoarseness, frequent throat clearing, globus hystericus (lump in throat), water brash, regurgitation, coughing, loss of dental enamel
What is pyrosis? heartburn
What is dyspepsia? upper abdominal pain/discomfort
Three esophageal complications of GERD 1) the effect of gastric acid on esophageal mucosa 2) esophagitis (inflammation) 3) Barrett's esophagus (precancerous lesion)
What are some respiratory complications of GERD? cough, bronchospasm, laryngosapasm, possible asthma, bronchitis, pneumonia
What is GERD? Chronic symptoms or mucosal damage due to reflux of gastric contents into the lower esophagus
What is the most common upper GI problem in adults? GERD
Four goals of drug therapy for GERD 1) decrease volume and acidity of reflux 2) improve lower esophageal sphincter function 3) increase esophageal clearance 4) protect the esophageal mucosa
What do proton pump inhibitors (PPI) do for the patient with GERD? They reduce the amount of acid produced by the stomach
What do histamine-2 (H2) antagonists (receptor blockers) do for the GERD patient? They reduce the amount of acid produced by the stomach
What do antacids do for the GERD patient? Antacids neutralize acid
What do promotility (GI stimulants) do for the patient with GERD? Promotility drugs treat reflux by increasing lower esophageal sphincter (LES) tone and enhancing emptying of food from the stomach
How do cytoprotective drugs help the patient with GERD? they work by forming a material that adheres to the lining of the esophagus, providing a protective barrier against stomach acid. If irritation is already present, the barrier will coat the damage and allow it to heal.
What is the goal of cholinergic drugs in the GERD patient? To improve lower esophageal sphincter function
Source of 50% of upper GI bleeds? Stomach/Duodenum-peptic ulcers
What are the two types of upper gastrointestinal (UGI) bleeding? Obvious and Occult
What are the two types of obvious UGI bleeding? hematemesis and melena
hematemesis bright red or "coffee ground" emesis
melena black tarry stools
How do you detect occult blood? guaiac test
The longer the passage of blood through the intestines, the _______ the stool color darker
clinical important bleeding can result in: decreased BP, increased pulse, decrease in hemoglobin by more than 2g/dL
What would you assess if you suspect an upper GI bleed? BP, pulse, signs of shock, medications, previous episodes, liver disease
What could a tense, rigid, boardlike abdomen indicate? perforation or peritonitis
What labs would you expect to be monitoring for an upper GI bleed? CBC, electrolytes, LFTs, guaiac stools
Created by: ld23012