digestive tract disorders part 2 Flashcards
Inflammation of the parotid glands
Parotitis
Cause of Parotitis
Causes painful swelling of the salivary glands below the ear next to the lower jaw; pain increases during eating
treatment Parotitis
Treated with antibiotics, mouthwashes, and warm compresses; surgical drainage or removal may be necessary
has no known cause; affects men more often than women, usually diagnosed in th 5th/6th decade if life, usually do not experience symtpoms until the disease has progressed to interfere with swallowing and passage of food
Esophageal Cancer
predisposing factors of Esophageal Cancer
are cigarette smoking, excessive alcohol intake, chronic trauma, poor oral hygiene, and eating spicy foods
s/s of Esophageal Cancer
Progressive dysphagia
medical diagnosis of esophageal cancer
Barium swallow, computed tomography, esophagoscopy, and endoscopic ultrasonography
Medical and surgical treatment
Esophageal Cancer
Surgery, radiation, chemotherapy, or various combinations
Nursing assessment of Esophageal Cancer
Dysphagia, pain, and choking
Hoarseness, cough, anorexia, weight loss, and regurgitation
The functional assessment documents the use of alcohol and tobacco and dietary practices
nursing interventions Esophageal Cancer
Pain Imbalanced Nutrition: Less Than Body Requirements Anxiety Risk for Injury Impaired Gas Exchange Deficient Knowledge
sometimes referred to as queasiness
Nausea
forceful expulsion of stomach contents through the mouth
Vomiting
Complications of N/V
Significant losses of fluids and electrolytes
Aspiration
Medical treatment of N/V
Antiemetics
Intravenous fluids
Oral fluids may be limited to clear liquids or withheld
Nasogastric tube
Nursing assessment of N/V
Onset, frequency, and duration of present illness
Conditions under which nausea and vomiting occur
Amount, color, odor, and contents of the vomitus
Surgeries, chronic illnesses, allergies, and medications
General appearance; record vital signs, height/weight
Assess pulse and blood pressure, tissue turgor, mental status, and muscle tone
Inspect, auscultate, and palpate the abdomen for distention, bowel sounds, and tenderness
Nursing interventions for N/V
Imbalanced Nutrition and Deficient Fluid Volume
Risk for Aspiration
Causes of N/V
drugs, infections and inflammatory conditions, intestinal obstruction, systemic infection, food poisoning, emotional stress,early pregnancy, uremia
The vomiting center that is located in the ? is particularly sensitive to
Medulla
parasympathetic neurotransmitters/gastric irritation
accompanies the forceful expulsion of the stomach contents causes dizziness hypotension bradycardia
The Valsalva maneuver
lab levels of N/V
Prolonged vomiting may lead to low levels of serum sodium and chloride. Bicarb levels may rise
How do you advance a client solids food if they are having N/V
When clients tolerates clear liquids, advance to full liquids then to soft, bland food such as creamed soup, crackers or toast
When patient returns from the operating room after oral surgery,
• they should be positioned flat on abdomen or side with head turned to the side to facilitate drainage from mouth. After recovery from anesthesia the client is positioned with head elevated
The nurse should not irrigate the clients mouth until the client is
awake and alert
Mouth irrigation is carried out by
turning the clients head to the side to allow the solution to run
Protrusion of lower esophagus and stomach up through the diaphragm and into the chest
Protrusion of part of the stomach into lower portion of the thorax
Hiatal Hernia
is the junction of the stomach and the esophagus and part of the stomach slide in and out through the weekend portion of the diaphragm
axial or sliding hernia
the fundus is displaces upward with greater curvature of the stomach going through the diaphragm next to the gastroesphageal junction
paraesophageal hernia
Hiatal hernia results in a defect in the
diaphragm at the point where the esophagus passes though it. more common in women
Causes of hiatal hernias
Weakness of diaphragm muscles where esophagus and stomach join, but exact cause is not known
Factors are excessive intra-abdominal pressure, trauma, and long-term bed rest in a reclining position
S/S of hiatal hernias
Many people have no symptoms at all; others report feelings of fullness, dysphagia, eructation, regurgitation, and heartburn
Medical diagnosis of hiatal hernias
Barium swallow examination with fluoroscopy
Esophagoscopy
Esophageal manometry
medical treatment of hiatal hernias
Drug therapy, diet, and measures to avoid increased intra-abdominal pressure
Surgery: fundoplication and placement of the synthetic Angelchik prosthesis (C-shaped silicone device), antacids
nursing assessment of hiatal hernias
Document symptoms
Record factors that trigger symptoms as well as measures that aggravate or relieve them
Patient’s dietary habits, use of alcohol and tobacco, and medication history
nursing interventions of hiatal hernias
Chronic Pain
Risk for Aspiration
Imbalanced Nutrition: Less Than Body Requirements
postoperative care for hiatal hernia
Turning, coughing, and deep breathing
Patient might have nasogastric tube in place and connected to suction for a day or two
Until bowel function returns, the patient is given only intravenous fluids
Tell the patient to expect mild dysphagia for several weeks
Painful burning sensation that moves up and down, commonly occurs after meals, and is relieved by antacids
is a common disorder that develops when gastric contents flow upward into the esphagus
GERDS
medical diagnosis of GERDS
Suggested by the signs and symptoms
Endoscopy, biopsy, gastric analysis, esophageal manometry, 24-hour monitoring of esophageal pH, and acid perfusion tests
medical treatment of GERDS
Like those described earlier for hiatal hernia
Drug therapy may include H2-receptor blockers, prokinetic agents, and proton pump inhibitors
If medical care unsuccessful, surgical fundoplication
weight loss, maintain upright position following meals, elevate head of bed when sleeping, avoid food and fluids 2-3 h before bedtime and avoid foods that intensify symptoms
Cause of GERDS
inability of the lower esophageal sphincter to close fully, allowing stomach contents to flow freely into esophagus
S/S of GERDS
most common is epigastric pain/discomfort (dyspepsia), burning sensation in the esophagus (pyrosis), and regurgitation, dysphagia, painful swallowing, esophagitis
because the esophagus is anatomically close to the heart, clients w/ epigastric pain may think they are having a
heart attack
is a procedure that tightens the LES by wrapping the gastric fundus around the lower esophagus and suturing it into place, this is the most common type of procedure for GERD
fundoplication
