digestive tract disorders Flashcards
The first section of the large intestine is the
cecum
colon goes up right side of the abdomen
Ascending
colon crosses abdomen just below waist
Transverse
colon goes down left side of abdomen
Descending
Age-Related Changes
Teeth are mechanically worn down with age
The jaw may be affected by osteoarthritis
A significant loss of taste buds with age
Xerostomia (dry mouth) is common
Walls of esophagus and stomach thin with aging, and secretions lessen
Production of hydrochloric acid and digestive enzymes decreases
Gastric motor activity slows
Movement of contents through the colon is slower
Anal sphincter tone and strength decrease
Abdomen
Inspection
Auscultation
Percussion
Palpation
Gastrointestinal Surgery
Preoperative nursing care
digestive tract is usually cleansed
Magnesium citrate or large-volume cathartic (laxative) solutions; enemas
Diet limited to liquids 24 hours before surgery, NPO after midnight
Intravenous fluids started preop
Oral antibiotics
Nasogastric tube inserted and attached to suction (often in surgery
Gastrointestinal Surgery
Postoperative nursing care
Be sure gastrointestinal suction is draining (low intermittent)
Inspect, describe, and measure the drainage
Assess abdomen for distention and bowel sounds
Administer intravenous fluids
Start out NPO, later may add ice chips
Keep strict intake and output records
Drug therapy
Emetics, antiemetics, laxatives, cathartics, antidiarrheals, antacids, anticholinergics, mucosal barriers, histamine-2 (H2)-receptor blockers, prostaglandins, and antibiotics
lack of appetite, leads to malnutrition
Anorexia
Appetite center is located in the
Hypothalamus
is the conversion of glycogen to glucose
Glycogeolysis
Cause of anorexia
Nausea, decreased sense of taste or smell, mouth disorders, and medications
Emotional problems associated with anorexia such as anxiety, depression, or disturbing thoughts
anxiety, depression, or disturbing thoughts
s/s of anorexia
hunger is absent, no desire of food, nausea may show hypovitaminosis (vitamin deficiency) body does not store any water soluble vitamins except B12
What are the labs with anorexia
hemoglobin level and blood count are reduced, RBC become enlarged. Serum albumin, electrolyte, protein levels are low.
Short term anorexia needs
no medical management
Persistent anorexia requires
high calorie diet, tube feedings,TPN, psychological support, psychiatric treatment.
Nursing management for anorexia-
sufficient nutrition maintain normal body weight monitor weight daily obtain client food history/patterns
Anorexia Nursing Interventions
Assist with oral hygiene before and after meals
Teach proper oral hygiene; refer for dental care
Relieve nausea before presenting a meal tray
Before serving meal tray, remove bedpans/emesis basins from sight, conceal drains and drainage collection devices, deodorize room if necessary
Socialization during mealtime
Respect food likes and dislikes
Position patient comfortably with easy access to food
A general term for inflammation of the oral mucosa
Stomatitis
Medical treatment for stomatitis
is directed toward determining the cause and eliminating it; a soft, bland diet may be ordered
Aphthous Stomatitis
canker sore
Aphthous Stomatitis can be caused by what? Characterized by what? and What medication use?
May be caused by a virus
Characterized by ulcers of the lips and mouth that recur at intervals
Topical or systemic steroids may be used
Yeastlike fungus causes the oral condition known as thrush or candidiasis
Candida albicans
Candida albicans what does it look like? What pt are high risk? What is the treatment?
Bluish white lesions on the mucous membranes
Patients at high risk include those on steroid or long-term antibiotic therapy
Treated with oral or topical antifungal agents; vaginal nystatin tablets can be used like lozenges and allowed to dissolve in the mouth
Ulcers and vesicles in mouth and on lips
Herpes simplex type 1
Herpes simplex type 1 occur when? and What medication use?
Occur with upper respiratory tract infections, excessive sun exposure, or stress
Spirits of camphor, topical steroids, and antiviral agents as treatment
Nursing Assessment of Herpes simplex type 1
Pain location, onset, and precipitating factors
Record any known illnesses and treatments, including drugs and radiation therapy
Describe habits, including diet, oral care practices, alcohol intake, and use of tobacco
Assess patient’s stress level
Inspect lips and oral cavity for redness, swelling, and lesions
Nursing interventions of Herpes Simplex type 1
Gentle oral hygiene, prescribed mouthwashes
The teeth and tongue can be cleansed with a soft-bristle toothbrush, sponge, or cotton-tipped applicator
Medications must be given as ordered
A destructive process of tooth decay
Dental Caries
Treatment for Dental Caries
The only treatment for dental caries is removal of the decayed part of the tooth, followed by filling the cavity with a restorative material
Begins with gingivitis; progresses to involve the other structures that support the teeth
Periodontal Disease
s/s of Periodontal Disease
Gums red, swollen, painful, and bleed easily
Primarily from inadequate oral hygiene
treatment of Periodontal Disease
Treatment in early stage: dental care for teeth cleaning and correction of contributing problems
Untreated, abscesses develop around the roots, the teeth loosen, and extraction is necessary
Nursing assessment of Periodontal Disease
Observe condition of teeth and gums
Document missing or broken teeth, caries, redness or lesions of the gums, and gum recession
Nursing interventions of Periodontal Disease
Most patients are treated for dental and gum conditions in dentists’ offices
Interventions directed at minimizing pain until the problem can be corrected by a dentist
Provide oral care for patients who cannot do it themselves
Squamous cell carcinoma (most common) and basal cell carcinoma that may effects the lips, mouth or pharynx that under go malignant changes if detected early cure rates are fairly good
cancer of the oral cavity
Cancer of the lip related
to prolonged exposure to irritants, including sun, wind, and pipe smoking
Factors that increase the risk of cancers inside the mouth include
tobacco and alcohol use, poor nutritional status, and chronic irritation
s/s of oral cancer
Tongue irritation, loose teeth, and pain in the tongue or ear
Malignant lesions may appear as ulcerations, thickened or rough areas, or sore spots
Leukoplakia: hard, white patches in the mouth; premalignant
Treatment includes of oral cancer
surgery, radiation, or chemotherapy, or a combination of these A neck dissection is performed if cancer has spread to the lymph nodes
nursing assessment of oral cancer
History of prolonged sun exposure, tobacco use, or alcohol consumption
Assess for difficulty swallowing or chewing, decreased appetite, weight loss, change in fit of dentures, and hemoptysis
The physical examination should focus on examination of the mouth for lesions
Assess the neck for limitation of movement and enlarged lymph nodes
Nursing interventions of oral cancer
Impaired Oral Mucous Membrane Ineffective Breathing Pattern Pain Imbalanced Nutrition: Less Than Body Requirements Impaired Verbal Communication Disturbed Body Image Risk for Infection Ineffective Tissue Perfusion
Nursing management of oral cancer
maintain pt airway, promoting adequate fluid/food intake, being patient with pt communication by speaking and clarification or repeat what pt says
