Ch. 49 Oral Cavity & Esophageal Problems Flashcards
All oral disorders/diseases
High risk for aspiration, airway concerns, stridor, dyspnea, painful lesions
Stomatitis
Inflammation/infection due to allergy, vitamin deficiency, systemic disease, irritants
Disrupts person’s ability to talk, eat, or sleep and can affect any part of the oral cavity
Candida in older adults
Can cause stomatitis
Age-related, long-term ABO, fungal infection pain
Decreases nutrition and oral intake
Candidiasis or Thrush
Causes: dentures, smoking, medications (ABX, corticosteroids, side effects of meds that can cause dry mouth)
High risk patients: immunocompromised patients, cancer
Stomatitis Interventions
Drug therapy: antifungals, lidocaine and Benadryl
Risk education and lifestyle changes
Encourage drug therapy w/ side effects
Diet options to preserve tissue integrity
Pain management
Support, coping, reassurance
Dietitian
Oral Disease/Disorder Education
Aspiration risk
Nutrition due to pain/unable to eat
Drug therapy as prescribed
Body image
Communication
Gastroesophageal Reflux (GERD)
Common upper GI disorder where back flow of stomach contents into esophagus (regurgitation)
GERD Risk Factors
Obesity, Gastritis, H Pylori, Food & drinks, Caffeine, Citrus, Alcohol, Smoking, Chocolate, NG tube
If GERD is untreated it can lead to what?
Barrett’s Esophagus
(risk for esophageal cancer)
GERD Complications
Asthma, Cough/Wheezing, Aspiration, Dental decay, Cardiac disease esophageal irritability, Hemorrhage, Aspiration pneumonia, Barrett’s esophagitis
Clinical Manifestations of GERD
Dyspepsia (indigestion)
Coughing, hoarseness, or wheezing at night
Pyrosis (heartburn)
Epigastric pain
Belching
Nausea
Chest pain
Sour stomach
Full Sensation
GERD Interventions
Pain management (GERD meds)
Balancing nutrition
Small, frequent meals
Limit fat, fried, or spicy foods
Sit up 1 hr after eating
Avoid eating 2 hr before bed
Elevate HOB
Education, lifestyle, modifiable risk factors
GERD Drug Therapy
Antacids - OTC meds, Gaviscon, Tums, Pepsi Bismol, Mallow
Histamin Blockers - Zantac, Pepcid, Tagamet, Axid
Proton Pump Inhibitors (PPIs) - Protonix, Nexium, Prilosec, Prevacid
Sialadenitis Interventions
Acute inflammation of salivary gland
Assessment - oral cavity visualization, facial cranial nerves, fever or malaise
Treatment - treat underlying cause, radiation or chemotherapy
Post Op Education for any GI Surgery
Soft diet
PPI/H2 blockers
Avoid heavy lifting
Wound care and follow up
Esophageal Tumors
High risk for metastasis with mucosa/lymph tissue to spread
High risk for aspiration
Assess ABCs
Esophageal Tumors Risk Factors
Alcohol
Obesity w/ central fat
Smoking
GERD
Deficient in fruit and vegetables
High nitrates in foods (pickled or fermented)
Esophageal Tumor Interventions
Oral and airway management
Monitor nutrition, swallow issues, hydration
Psychosocial aspects
Speech therapy
Diet specialist
Chemo/Radiation
Clinical Manifestations of Esophageal Tumor
Asymptomatic (early)
Persistent and progressive dysphagia
Feeling of food sticking in throat
Odynophagia (painful swallowing)
Hoarseness
Regurgitation
N/V
Weight loss
Esophageal Trauma
Blunt trauma or strangulation
Inhalation
Severe vomiting
Chemical burns/injury w/ ingestion of caustic substances
Esophageal Trauma Nursing Priorities
Assess airway patency
Breathing and chest pain
Vomiting or bleeding
Nutrition status
Sepsis risk
Esophageal Trauma Interventions
NPO
Drug therapy - Steroids, Pain meds, ABX
Nutrition education - NG for nutrition
Watch for sepsis
