Ch. 49 Oral Cavity & Esophageal Problems

Question 1

All oral disorders/diseases

Answer 1

High risk for aspiration, airway concerns, stridor, dyspnea, painful lesions

Question 2

Stomatitis

Answer 2

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

Question 3

Candida in older adults

Answer 3

Can cause stomatitis
Age-related, long-term ABO, fungal infection pain
Decreases nutrition and oral intake

Question 4

Candidiasis or Thrush

Answer 4

Causes: dentures, smoking, medications (ABX, corticosteroids, side effects of meds that can cause dry mouth)
High risk patients: immunocompromised patients, cancer

Question 5

Stomatitis Interventions

Answer 5

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

Question 6

Oral Disease/Disorder Education

Answer 6

Aspiration risk
Nutrition due to pain/unable to eat
Drug therapy as prescribed
Body image
Communication

Question 7

Gastroesophageal Reflux (GERD)

Answer 7

Common upper GI disorder where back flow of stomach contents into esophagus (regurgitation)

Question 8

GERD Risk Factors

Answer 8

Obesity, Gastritis, H Pylori, Food & drinks, Caffeine, Citrus, Alcohol, Smoking, Chocolate, NG tube

Question 9

If GERD is untreated it can lead to what?

Answer 9

Barrett’s Esophagus
(risk for esophageal cancer)

Question 10

GERD Complications

Answer 10

Asthma, Cough/Wheezing, Aspiration, Dental decay, Cardiac disease esophageal irritability, Hemorrhage, Aspiration pneumonia, Barrett’s esophagitis

Question 11

Clinical Manifestations of GERD

Answer 11

Dyspepsia (indigestion)
Coughing, hoarseness, or wheezing at night
Pyrosis (heartburn)
Epigastric pain
Belching
Nausea
Chest pain
Sour stomach
Full Sensation

Question 12

GERD Interventions

Answer 12

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

Question 13

GERD Drug Therapy

Answer 13

Antacids - OTC meds, Gaviscon, Tums, Pepsi Bismol, Mallow
Histamin Blockers - Zantac, Pepcid, Tagamet, Axid
Proton Pump Inhibitors (PPIs) - Protonix, Nexium, Prilosec, Prevacid

Question 14

Sialadenitis Interventions

Answer 14

Acute inflammation of salivary gland
Assessment - oral cavity visualization, facial cranial nerves, fever or malaise
Treatment - treat underlying cause, radiation or chemotherapy

Question 15

Post Op Education for any GI Surgery

Answer 15

Soft diet
PPI/H2 blockers
Avoid heavy lifting
Wound care and follow up

Question 16

Esophageal Tumors

Answer 16

High risk for metastasis with mucosa/lymph tissue to spread
High risk for aspiration
Assess ABCs

Question 17

Esophageal Tumors Risk Factors

Answer 17

Alcohol
Obesity w/ central fat
Smoking
GERD
Deficient in fruit and vegetables
High nitrates in foods (pickled or fermented)

Question 18

Esophageal Tumor Interventions

Answer 18

Oral and airway management
Monitor nutrition, swallow issues, hydration
Psychosocial aspects
Speech therapy
Diet specialist
Chemo/Radiation

Question 19

Clinical Manifestations of Esophageal Tumor

Answer 19

Asymptomatic (early)
Persistent and progressive dysphagia
Feeling of food sticking in throat
Odynophagia (painful swallowing)
Hoarseness
Regurgitation
N/V
Weight loss

Question 20

Esophageal Trauma

Answer 20

Blunt trauma or strangulation
Inhalation
Severe vomiting
Chemical burns/injury w/ ingestion of caustic substances

Question 21

Esophageal Trauma Nursing Priorities

Answer 21

Assess airway patency
Breathing and chest pain
Vomiting or bleeding
Nutrition status
Sepsis risk

Question 22

Esophageal Trauma Interventions

Answer 22

NPO
Drug therapy - Steroids, Pain meds, ABX
Nutrition education - NG for nutrition
Watch for sepsis