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adults > oral and esophageal disorders > Flashcards

oral and esophageal disorders Flashcards

1
Q

periodontal disease is conencted to systemic diseases like…

A
  • CVD
  • DM
  • RA
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2
Q

what is the most common cause of tooth loss among adults

A

periodontal disease

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3
Q

who is at greater risk for periodontal disease

A
  • increased age
  • balck or hispanic
  • current smokers
  • lack of dental care (low SES)
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4
Q

what are some dental health considerations for the older adult

A

meds

poor dentition can exacerbate:
- decreased food intake, loss of appetite
- social isolation
- increased susceptibility to systemic infection
- trauma to oral cavity secondary to thinner, less vascular oral mucous membranes

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5
Q

what is plaque

A
  • sticky layer of bacteria
  • eating foods high in sugar
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6
Q

what si tartar

A

plaque but mineralized on your teeth

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7
Q

what are some keys to oral care in the inpatient

A
  • healthy teeth must be cleaned on a daily basis
  • mastication and saliva aid in keeping teeth clean: not eating or dry mouth -> bad
  • nurse must brush teeth -> if you cant brush, wipe em with gauze pad and swish
  • prevent drying lips, coat with water soluble gel
  • promote good diet low in sugar and starch
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8
Q

what are some causes of esophageal perforation

A
  • boerhaave syndrome (75%) - forceful emesis
  • procedures (NG/EGD/ET)
  • chemical ingestion
  • foreign bodies
  • stab/gunshot
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9
Q

whats happening with esophageal perforation

A
  • opening in esophagus
  • contets into mediastinum (systemic inflammatory response)
  • can lead to sepsis
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10
Q

how will a client with esophageal perforation present

A
  • neck/shoulder/upper and lower back issues
  • cannot lie flat
  • tachypnea and tachycardia
  • severe hypotension
  • fever and chills
  • dysphagia and vomiting
  • PAIN
  • might aspirate blood
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11
Q

what are some labs and diagnostics for esophageal perforation

A
  • fluoroscopy (be careful)
  • CT
  • EGD (not during acute phase)
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12
Q

what meds can help with esophageal perforation

A
  • pain control meds
  • broad spectrum antibiotics
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13
Q

what are some surgical interventions for esophageal perforation

A

from no surgery to minimal surgery to major surgery

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14
Q

what are some complications of esophageal perforation

A
  • pneumonia
  • sepsis
  • death
  • ARDS
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15
Q

describe nursing focus and education for esophageal perforation

A
  • discuss risks and signs of perforation prior to procedures
  • NPO x 1 month (TPN/PPN)
  • add liqs back in first and progress
  • if major surgery = no food x 6mo
  • if no food provide good oral care
  • discuss reperforation
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16
Q

what are some causes of foreign bodies in the esophagus

A
  • not properly chewing food
  • dumbass kids shoving things in their mouth
  • fish bones
  • grapes, peanuts, candies, hot dogs (HA)
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17
Q

how will the client present with foreign bodies in the esophagus

A
  • acute dysphagia
  • complete = increased saliva/dysphagia
  • odynophagia (painful swallowing)
  • gagging and choking
  • CP
18
Q

what are some labs and diagnostics for foreign bodies in the esophagus

A
  • xray
  • fluoroscopy/EGD
19
Q

whats a complication of foreign bodies in the esophagus

A

obstruction and perforation

20
Q

what med may help with foreign bodies in the esophagus

A

glucagon

no idea why tho

21
Q

whats a surgical intervention for foreign bodies in the esophagus

A

EGD

22
Q

how can nurses help with foreign bodies in the esophagus

A
  • teach perent about small shit and their dumbass kids
  • follow up with GI
23
Q

what are some causes of chemical burns of esophagus

A
  • acid/base
  • intentional/unintentional
  • meds
24
Q

how will the client present with chemical burns of esophagus

A
  • dysphagia
  • stridor, wheezing, dyspnea, tachypnea
  • abdominal tenderness and guarding
  • bleeding and shock
  • may need intubation
25
Q

what are some labs and diagnostics for chemical burns of esophagus

A
  • chest and abdominal xray
  • eventual EGD when healed
26
Q

what are some meds that can help with chemical burns of esophagus

A
  • corticosteroids
  • antibiotics if infection
27
Q

what are some acute interventions for chemical burns of esophagus

A
  • DO NOT induce vomiting
  • prepare for emergent intubation
  • neutralizing chemicals
28
Q

how can nurses help with chemical burns of esophagus

A
  • talk to parents about possible toxins
  • know poison control number 1-800-222-1222
  • discuss long term complications
  • if suicide attempt to refer to couneling
  • enteral feedings (G/J tube)
  • pneumatic dilation (fix scar tissue)
29
Q

what are some causes of GERD

A
  • incompetent LES (little sphincter guy)
  • hiatal hernia
  • pregnancy
  • motility disorder
30
Q

whats happening with GERD

A

backflow of acid = esophagitis

31
Q

how will the clint present with GERD

A
  • pyrosis (heartburn)
  • CP
  • dysphagia
  • dyspepsia/regurgitation
  • sensation in throat
  • disrupted sleep
32
Q

what are some complications of GERD

A
  • esophageal stricture
  • esophaheal ulcer
  • barrett’s esophagus (precancerous change)
33
Q

what are some labs and diagnostics for GERD

A
  • EGD
  • fluoroscopy
34
Q

what are some surgical interventions for GERD

A
  • Nissen fundoplication
  • LINX
35
Q

what meds can help with GERD

A
  • anatacids (tums)
  • H2s (famotidine): as neesed, reduce stomach acid, can inhibit B12 absorption
  • PPIs (omeprazole): daily, can inhibit B12 absorption
  • prokinetics (metoclopramide): if caused by slow motility
36
Q

how can nurses help with GERD

A
  • maintain a healthy weight
  • stop smoking
  • elevate HOB
  • stay upright after meals
  • avoid triggers
  • avoid tight fitting clothes
  • herbal and relaxtion therapies
  • follow up if worsened
  • twizzlers
37
Q

name the two major types of esophageal cancer

A
  • adenocarcinoma
  • squamous cell carcinoma
38
Q

what are some risk factors for adenocarcinoma

A
  • GERD
  • alcohol/tobacco
  • barretts esophagus
39
Q

what are some risk factors for squamous cell carcinoma

A
  • chronic ingestion hot/cold foods
  • poor oral hygiene
  • alcohol/tobacco
  • nutritional deficiencies
  • caustic injury to esophagus
40
Q

what is esophageal cancer primarily found

A
  • distal esophagus
  • gastroesophageal junction
41
Q

describe treatment of esophageal cancer

A
  • if detected early = curable
  • late = treat symptoms
  • surgery, radiation, chemo
  • esophagectomy

adults (51 decks)

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