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CH 38 M-IV
CH 38 Disorders affecting ingestion
| Question | Answer |
|---|---|
| lack of appetite is called: | anorexia |
| medical diagnosis of anorexia | serum hemoglobin, iron, total iron-binding capacity, transferrin, calcium, folate, B12, zinc |
| Dx of anorexia to find metabolic disorders | thyroid function test |
| Why is a skin test performed when diagnosing anorexia | assessing for allergies |
| What are significant assessments for anorexia | pain, nausea, dyspnea, and extreme fatigue |
| name 5 signs of malnutrition | glossitis, cheilosis, edema, jaundice, muscle wasting |
| Glossitis | inflammation of the tongue |
| cheilosis | cracked lips |
| Pt reports having possible anorexia because he doesn't eat. Pt. has dentures, what should the nurse evaluate for | do the dentures fit. Have dentures removed before gums are assessed |
| a general term for information of the oral mucosa | stomatitis |
| what are the possible medical treatments for stomatitis? | Antibiotics-usually topical, antiviral agents, soft bland diet |
| bacterial infection that causes a metallic taste | Vincent's infection |
| what is another name for Vincent's infection? why is it called this? | trench mouth; often developed among soldiers in World War I |
| trench mouth causes a metallic taste and bleeding___in the mouth,___breath, and increase___ | ulcers, foul, salivation |
| S/Sx of vincent's infection/trench mouth | metallic taste, bleeding ulcers in the mouth, bad breath, increase salivation, fever, enlarged lymph nodes, anorexia |
| Treatment for vincent's Infection: | topical antibiotics, mouthwashes |
| herpes simplex is caused by what? | Herpes simplex virus type I |
| S/Sx of herpes simplex | ulcers and vesicles in the mouth and lips-cold sores or fever blisters |
| risk factors of herpes simplex | upper respiratory tract infection, excessive sun exposure, stress |
| treatment for herpes simplex | spirits camphor, topical steroids, anti-viral agents |
| another name for canker sores | Aphthous Stomatitis |
| canker sore's are characterized by ulcers of the lips and mouth that recur at__ | intervals |
| treatment for canker sores | topical or systemic steroids |
| yeast-like fungus, causes the oral condition known as thrush | Candida albican |
| another name for thrush | candidiasis |
| S/Sx of thrush | bluish white lesions |
| risk factors for thrush | steroid users, long-term antibiotic therapy |
| treatment of thrush | topical antifungal agents, vaginal nystatin tablets (lozenges) |
| what is a nurse's role for patients with oral inflammation or infection? Why is it limited to that role? | teaching; patients are treated as outpatients |
| a drug was prescribed for patient would stomatitis. What may be an important teaching for this patient regarding medication? | Swish and swallow the meditation |
| was the only treatment for tooth decay/dental caries | removal of the decayed part of the tooth |
| what a preventive measures for dental caries | good oral hygiene and nutrition, limiting sugar intake-some off watches containing sugar and alcohol |
| gingivitis results primarily from what? | Poor oral hygiene |
| patient teachings for disorders of the teeth and gums | periodic dental examinations, brush teeth the least twice a day, floss every day, eat balanced diet, limited sugar intake |
| what is the most life-threatening disorder affecting the mouth? | Oral cancer |
| name two types of oral cancer | squamous cell carcinoma and Basal cell carcinoma |
| most common site for basal cell carcinoma is? | Lips |
| squamous cell carcinoma are seen where? | buccal mucosa, gums, floor of the mouth, tonsils, Tongue |
| risk factors for Cancer of the lip (basal) | exposure to irritatants: sun, wind, and pipe smoking |
| risk factors for cancer inside of the mouth (squamous) | tobacco and alcohol especially combined, poor nutrition, chronic irritation |
| S/Sx of oral cancer: tongue ___, pain in the tongue or __, loose ____, malignant thick rough ___ or ___ | irritation, ear, teeth, ulcers/sores |
| Leukoplakia is considered a ____ condition | premalignant condition |
| Dx of Oral cancer | biopsy |
| oral cancer: what else is ordered when cancer is confirmed? why are they ordered? | endoscopic examinations and radiographs of the upper digestive and respiratory tracts; check of metastates |
| Treatment for oral cancer includes 3 things | surgery, chemotherapy, radiation, or combination of these |
| Oral cancer: treatment for small lesions | excised and sutured |
| Oral Cancer: treatment for large lesions | incision made along the jawbone for access, grafts taken from anterior thigh to close large defects |
| during evaluation of the patient with possible oral cancer, it is especially important to note a history of: | prolonged sun exposure, tobacco use, or alcohol, family history of cancer |
| significant signs and symptoms of oral cancer to record are: | dsyphagia, difficulty chewing, decreased appetite, weight loss, changing denture fitting, hemoptysis, lesions |
| Oral Cancer: physical examination should focus on: | lesions of mouth, Ltd. neck movement, enlarged lymph nodes |
| Oral Cancer: radiation therapy complications are | edema, dry mouth |
| Oral Cancer: Before admin mouth care for pts who had oral surgery and radiation, what should the nurse do? | consult w/ physician |
| Oral Cancer surgery: Temp is taken by what routes | tympanic and rectal |
| Oral Cancer surgery: physicians may order specific solutions. Name two types | 1) 1/2 hydrogen peroxide and 1/2 NS 2) 1/2 tsp backing soda and 8 oz. of water |
| IMPORATANT-Oral cancer surgery: What causes ineffective airway? | edema, secretions, enlarged tumor |
| Important: What should you monitor for? | resp status frequently, report sx of inadequate O2 |
| S/Sx of inadequate O2 | dsypnea, restlessness, tachycardia |
| What are interventions for obstructed airway in an oral cancer pt. | edema = HOB elevated, steroids; secretions = suction, steroids; tracheotomy |
| Oral cancer surgery: Grafts are often needed, what is the primary concern for the nurse? | maintaining adequate blood supply so tissue remains alive: |
| nursing interventions regarding grafts are to monitor grafts ___ and ___, protect graft from ___. | warmth and color; pressure |
| what s/sx regarding grafts should be reported to physician | coolness, darkness |
| a condition where there is a progressive worsening of dsyphagia | achalasia |
| pathophysiology of achalasia | failure of esophageal muscles and sphincter to relax during swallowing |
| what is a cause of achalasia | unknown |
| Achalasia:What is the main complication of esophageal dilation? (injection of botulinum toxin) | perforation |
| Achalasia: interventions decreasing symptoms are to eliminate _____ that may cause problems, find ____ for eating, avoid ____ clothing, ___ HOB | foods; best position; restrictive; elevate HOB to control esophageal reflux |
| is cancer of the esophagus common | no |
| Esophageal cancer has a good prognosis: T or F | False |
| Esophageal cancer: risk factors | cigarette, excessive alcohol, chronic trauma, poor oral hygiene, spicy foods |
| Esophageal cancer: What often happens by the time it is diagnosed? | metastasize |
| Esophageal cancer:common places for metastasis | liver/lung |
| Esophageal cancer:what can cause erosion and hemorrhage | lesions metastasizing to aorta |
| Esophageal cancer: complications | perforation, hemorrhage, erosion, obstruction of esophagus |
| Esophageal cancer: Primary symptom | progressive dysphagia - achalasia |
| Esophageal cancer:Pts have difficult swallowing ____ first, then ___, and finally ___ | meat; soft foods, liquids |
| Esophageal cancer: Obstruction indicates what stage? | late stage |
| Esophageal cancer: s/sx | achalasia, sore throat, obstruction, pain w/ swallowing: substernal, epigastric, back radiating to neck jaw ears shoulder |
| Esophageal cancer: Dx | barium swallow series, CT scan, endoscopic ultrasonography, esophagoscopy |
| esophagoscopy allows? | biopsy |
| Esophageal cancer:treatment | surgery, radiation, chemotherapy, or combination |
| chemotherapy or radiation therapy or enough to cure esophageal cancer: T or F | false |
| Esophageal cancer: name 4 types of surgery | esophagectomy, esophagogastrostomy, esophagogastrectomy, esophagoenterostomy |
| removal of all or part of esophagus and replacement of the resected part w/ a Dracron graft | esophagectomy |
| esophagogastrostomy | resection of the disease part of the esophagus and attachment of the remaining esophagus to the stomach |
| esophagogastrectomy | resection of lower esophagus and upper stomach. Then attach remain parts to each other |
| esophagoentorectomy/colon inerposition | replace diseased part of esophagus w/ colon |
| Esophageal cancer: pts. who are considered poor surgical risks may receive what? | Palliative care |
| Esophageal cancer: palliative care includes___of the esophagus, placement of___, __treatment to an endoscope, ___therapy (3 types) | dilation, stent, laser, therapies: chemotherapy, radiation, and for dynamic therapy |
| Esophageal cancer: dilation of the esophagus decreases? | dysphagia (injection of botulin toxin?) |
| explain photodynamic therapy | light-sensitive drug is given, then two days later a probe in the esophagus activates the drug = destroys only cancer cells |
| Esophageal cancer: what is a major challenge regarding this condition? What is the treatment? | Maintaining good nutrition; insert feeding tube = gastrostomy tube |
| Esophageal cancer assessment: name key data in health history | dsyphagia, pain, and choking |
| Esophageal cancer:Post-op pts usually have what kind of to attach to suction? what two things must you avoid? | NG tube; irrigate and reposition is a no no |
| Esophageal cancer post op: drainage characteristics | bloody first 8-12 hrs, gradually turns yellowish |
| Esophageal cancer post op: The anastomisis sites can be at risk for? | leakage |
| Esophageal cancer post op: leakage are at the greatest risk when? | 5-7 days after surgery |
| S/sx of leakage | fever, tachycardia, tachypnea, fluid accumulation |
| Esophageal cancer: pts. w/ stents should lie flat sometimes: T or F | false: avoid flat position at all times, should eat small meals, upright for several hours, HOB 30 degrees |
Created by:
Jgar2007
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