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Adult Health Pt 2 > Oral and Esophageal Disorders > Flashcards

Oral and Esophageal Disorders Flashcards

1
Q

Temporomandibular Joint Disorder (TMJ) S/S

A
  • pain w/ chewing
  • jaw pain (morning)
  • jaw joint popping/clicking
  • limited opening/ROM
  • worn, cracked, chipped teeth
  • loose, sore teeth
  • unstable tooth position
  • headaches
  • sinus pressure
  • neck/shoulder tension
  • sense of water in ears
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2
Q

Non-Surgical Treatment for TMJ

A
  • stress management
  • mouth guards for nights
  • ROM exercises
  • pain meds
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3
Q

Surgical Treatment for TMJ Fractures

A
  • insertion of metal plates and screws for stabilization
  • wiring of jaw shut for several weeks
  • may be stabilized using rubber bands
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4
Q

What are the 2 most common causes for TMJ?

A

Osteoarthritis or Dislocation of jaw

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5
Q

TMJ Nursing Management Post-OP

A
  • liquid/pureed diet
  • no chewing up to 4 weeks
  • keep wire cutters/scissors at bedside
  • may need straw
  • keep mouth clean-soft sponge or child sized tooth brush
  • report any ulcerations to provider
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6
Q

Parotitis

A

inflammation of parotid gland

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7
Q

Risk factors for Parotitis

A
  • decreased salivary flow
  • dehydration
  • meds
  • infections (mumps, flu, staph)
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8
Q

Parotitis S/S

A
  • primary condition
  • swollen, hardened, tender glands
  • ear pain
  • difficulty swallowing
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9
Q

Nursing Management for Parotitis

A
  • assist w/ adequate oral/dietary intake
  • oral hygiene
  • hold/DC meds r/t problems
  • antibiotics/pain meds
  • I&D
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10
Q

S/S for Oral cancers

A
  • asymptomatic until late stages
  • painless sore that is difficult to or will not heal
  • indurated (hard) w/ raised edges
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11
Q

Treatment for Oral Cancers

A
  • radiation therapy
  • chemotherapy
  • surgery
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12
Q

Radical Neck Dissection

A

all tissue on side of neck from jawbone to collar bone is removed
all muscle, nerve, salivary gland, and major blood vessel is removed

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13
Q

Modified Radical Neck Dissection

A
  • MOST COMMOM
  • all lymph nodes are removed
  • less neck tissue taken
  • may spare nerves and sometimes blood vessels or muscle
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14
Q

Selective Neck Dissection

A

if cancer has not spread far, fewer lymph nodes are removed

muscle, nerve, and blood vessel may be saved

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15
Q

Laryngectomy

A

permanent laryngeal stoma

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16
Q

Concerns for Laryngectomy

A
  • airway
  • communication
  • nutrition
  • body image
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17
Q

Nursing Management for Laryngectomy

A
  • dietary consult
  • assess swallowing
  • suctioning
  • monitor graft site
  • assess for excessive dry mouth
  • assess for stomatitis
  • dentistry may be needed
  • assess support system
18
Q

Airway Considerations

A
  • semi-fowlers position
  • assess for respiratory distress
  • auscultate lung sounds (stridor=call provider ASAP)
  • coughing/deep breathing
  • suction prn
  • assess swallowing
  • consult speech patho
19
Q

Wound Care

A
  • JP drain may remain for 3-5 days
  • drainage should decrease after 1st 24 hrs
  • reinforce dressing but do not remove
  • assess graft
  • assess for swelling
  • assess for infection
20
Q

Nutrition

A
  • assessment begins pre-operatively
  • enteral/parenteral feedings
  • diet modifications based on chewing/swallowing
  • oral care
21
Q

Communication and Mobility

A
  • pencil & paper
  • white board
  • communication board
  • PT/OT after drains removed and incision healing
  • early ambulation
22
Q

Monitor for Complications

A
  • hemorrhage
  • chyle fistula
  • nerve damage
23
Q

Chyle Fistula

A
  • assess for milky odorless discharge

- corrected through monitoring and diet or surgery

24
Q

Hiatal Hernia

A

part of stomach pushes upward through the opening in the diaphragm that the esophagus passes through

25
Q

S/S of Hiatal Hernia

A
  • asymptomatic
  • heartburn/chest pain
  • dysphagia
  • regurgitation
  • incarceration (strangulation) w/ obstruction
  • sudden severe pain
  • n/v
26
Q

Management for Hiatal Hernia

A
  • frequent small meals
  • sit up for 1 hr after meals
  • keep HOB elevated while sleeping
  • antacids
  • H2 antagonist
  • PPIs
  • surgery
27
Q

Diverticulum

A

abnormal sac/pouch that forms at weak point on the esophagus

28
Q

Diverticulum S/S

A
  • dysphagia
  • chronic bleeding
  • regurgitation
  • chronic bad breath
  • chest pain
29
Q

Management for Diverticulum

A
  • surgery
  • NPO until after non-leakage verified
  • CL advance as tolerated
30
Q

Causes of Esophageal Perforations

A
  • surgery
  • trauma
  • severe retching/vomiting
31
Q

S/S of Esophageal Perforations

A
  • persistent pain
  • dysphagia
  • trouble speaking/breathing
  • fever/leukocytosis
  • hypotension
32
Q

Management for Esophageal Perforations

A
  • broad spectrum antibiotics
  • minor wound symptoms: NPO, enteral, parenteral feedings up to 1 month or more, barium swallows, clear liquids
  • surgery
33
Q

Barium Swallow

A
  • patient drinks a preparation containing the solution and an x-ray is used to track its path through GI tract
  • 30-60 mins to complete
  • increase fluid and fiber intake to prevent constipation
34
Q

Gastroesophageal Reflux (GERD)

A

gastric and/or duodenal contents backflow into esophagus

35
Q

GERD may result from what?

A
  • obesity
  • weak lower esophageal sphincter
  • pyloric stenosis
  • motility disorder
36
Q

S/S of GERD

A
  • dyspepsia (indigestion)
  • regurgitation
  • dysphagia
  • odynophagia
  • excessive salivation
  • patient believes they are having MI
  • Barret’s Esophagus
37
Q

What is Barret’s Esophagus?

A

normal tissue lining in the esophagus changes to tissue that resembles the lining of the intestines

38
Q

Barret’s Esophagus increases your risk for developing what?

A

esophageal adenocarcinoma

39
Q

S/S of Barret’s Esophagus

A
  • narrowing of esophagus caused by inflammation and scar tissue
  • difficulty swallowing
  • coughing when eating or drinking
  • full feeling in throat
  • frequent belching
  • treatment w/ esophageal dilation
40
Q

Management of GERD/Barret’s Esophagus

A
  • low fat diet
  • avoid caffeine, alcohol, tobacco, milk, carbonated drinks
  • stop eating at least 1 hr before bed
  • sit up for 1 hr after eating
  • sleep with HOB elevated
  • meds: antacids, gastric emptying accelerators

Adult Health Pt 2 (8 decks)

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