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Medical Surgical Nursing > Disorders of Esophagus > Flashcards

Disorders of Esophagus Flashcards

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1
Q

Dysphagia

A

difficulty swallowing

most common symptom

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2
Q

Odynophagia

A

painful swallowing

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3
Q

Common Problem and Malfunction

Achalasia

A

absent or ineffective peristalsis of the distal esophagus

lower 2/3 of esophagus

  • most often in 40 year olds
  • incomplete relaxation of LES
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4
Q

Achalasia

Signs & Symptoms

A
  • Dysphagia
  • Sensation of food sticking in LES
  • Noncardiac chest/epigastric pain or heartburn
  • Secondary Pulmonary Complications
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5
Q

Achalasia

Assessment

A
  • X-ray studies
  • Barium swallow
  • CT scan of chest and endoscopy
  • Manometry

Manometry = confirmatory diagnostic examination

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6
Q

Achalasia

Management

A
  • Small frequent feedings
  • Ca channel blockers and nitrates
  • Pneumatic dilation
  • Esophagomyotomy
  • Endoscopic myotomy
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7
Q

Achalasia (Management)

Ca channel blockers and nitrates

A
  • ↓ esophageal pressure
  • improve swallowing
  • smooth muscle relaxants
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8
Q

Achalasia (Management)

Pneumatic dilation

A

stretch narrowed area

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9
Q

Achalasia (Management)

Esophagomyotomy

A

relax gastroesophageal junction

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10
Q

Achalasia (Management)

Endoscopic myotomy

A

pre-oral endoscopic myotomy (POEM)

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11
Q

Esophageal Spasm

A

abnormal muscle contractions in the esophagus

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12
Q

Esophageal Spasm

Types

A
  • Diffuse Esophageal Spasm
  • Hypertensive Peristalsis (Nutcracker Esophagus)

according to the book:
* DES
* Jackhammer esophagus
* Type III (spastic) achalasia

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13
Q

Type of Esophageal Spasm

Diffuse Esophageal Spasm

A
  • uncoordinated spasms
  • normal amplitude
  • moves quickly and upwards
  • only a portion is affected

regurgitate

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14
Q

Type of Esophageal Spasm

Jackhammer Esophagus (Hypercontractile Esophagus)

under Hypertensive Peristalsis

A
  • extreme form
  • coordinated movement
  • entire is affected
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15
Q

Esophageal Spasm

Signs & Symptoms

A
  • dysphagia
  • odynophagia
  • chest pain
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16
Q

Esophageal Spasm

Assessment

A

Esophageal Manometry

  • measures motility and internal pressure
  • LES
  • standard test
  • in side-lying position
17
Q

Esophageal Spasm

Management

A
  • Ca channel blockers
  • nitrates
  • smooth muscle relaxnts
  • anti-cholinergics
  • anti-anxiety
  • PPIs
  • soft diet
  • Heller myotomy/POEM
18
Q

Esophageal Spasm

Management

A
  • Ca channel blockers
  • nitrates
  • smooth muscle relaxnts
  • anti-cholinergics
  • anti-anxiety
  • PPIs
  • soft diet
  • Heller myotomy/POEM
19
Q

Esophageal Spasm (Management)

Ca channel blockers

A
  • first line of therapy
  • nifedipine, verapamil
20
Q

Esophageal Spasm (Management)

Ca channel blockers

A
  • first line of therapy
  • nifedipine, verapamil
21
Q

Esophageal Spasm (Management)

Smooth Muscle Relaxants

A
  • sildenafil/viagra
  • after relaxing effect
22
Q

Esophageal Spasm (Management)

Anticholinergics

A

Botulinum toxin

23
Q

Esophageal Spasm (Management)

Anti-anxiety

A

tricyclic antidepressants

24
Q

Esophageal Spasm (Management)

PPIs

A

omeprazole

25
Q

Esophageal Spasm (Management)

soft diet

A

↓ esophageal pressure and irritation

small frequent feedings

26
Q

Hiatal Hernia

A

opening in the diaphragm through which the esophagus passes becomes enlarged, and part of the upper stomach moves up into the lower portion of the thorax

outpouching

women > men

27
Q

Hiatal Hernia

Types

A
  • Sliding Hernia (Type I)
  • Paraesophageal/Rolling Hernia (Type II)
28
Q

Hiatal Hernia

Sliding Hernia

A
  • stomach and gastroesophageal junction are displaced upward
  • slides in and out

95% cases of hiatal hernia

Medical Surgical Nursing (2 decks)

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