Oral, Esophageal, Stomach Flashcards
Clotrimazole troches
Nystatin suspension
Chlorhexdine
Are medications for…
Stomatitis
Reduce risk of infection
Viscous lidocaine
Diphenhydramine liquid
Aluminum hydroxide, mag hydroxide, simethicone suspension.
Used for…
Pain reduction
Stomatitis
PASS acronym is used for….
Probable client will have swallowing difficulties
Account for previous swallowing problems
Screen for S/S
Speech-language pathologist
Use alcohol based mouthwash for Stomatitis
True or False
False
This will hurt
Red velvety mucosal lesion
Name
Cancerous?
Erythroplakia
Pre-cancerous
Thickened white firmly attached patches
Incidences Raise with Tobacco
Name/ Cancerous?
Leukoplakia
Most are benign
Oral hairy leukoplakia is seen in which type of patients
With compromised immune system
Most common type of oral cancer
On most parts of oral cavity
Squamous Cell carcinoma
This oral cancer is found mostly on the lips
Related to sunlight exposure
Doesn’t Metastasis but can involve skin of face
Basal cell carcinoma
Kaposi sarcoma
Vascular tumor
Purple, Red, Brown nodule or plaque
Associated with AIDS
Oral care how often
Q2h
Sialadenitis is….
inflammation or infection of the salivary glands
Esophageal spasm can lead to
Achalasia
Which is…
rare swallowing disorder that makes it difficult for food and liquid to pass from the esophagus into the stomach.
To diagnose esophageal spasm use one of these 3 test.
Barium swallow, esophageal manometry, upper GI endoscopy
Treatments for this disease include
Botulinum toxin injection
Muscle relaxant
Dilation procedures
Surgery
Esophageal spasm
Myotomy is….
a surgical procedure that involves cutting muscle fibers to weaken the lower esophageal sphincter (LES).
The LES is a ring of muscle at the bottom of the esophagus that allows food and liquids to pass into the stomach
Treatments for this disease include surgical resection or myotomy
Esophageal diverticula
Barrett’s esophagus is….
usually the result of repeated exposure to stomach acid. It’s most often diagnosed in people with long-term gastroesophageal reflux disease (GERD)
odynophagia
Painful swallowing
Globus…
a persistent or intermittent non-painful sensation of a lump or foreign body in the throat
Pyrosis =
Heartburn
For Gerd avoid medication that lowers LES.
These include
Oral contraceptive, anticholinergic, sedatives, NSAIDS, nitrates, calcium channel blockers
Gerd
Drug therapy
(3)
Antacids, Maalox, Mylanta, Gaviscon
Histamine Blockers: Famotidine, Climetidine
PPI: Suffix (Prazole) Priolosec
PPI may have this adverse side effect with older adults
Interfer with calcium absorption
Broken hips / brittle bones
Laparoscopic Nissen fundoplication
&
LINX Refux Management System
Device that augments the LES with a ring of magnets (CAUTION MRI)
Are used for which condition
GERD
Gastric volvulus is…
a rare condition that occurs when the stomach rotates more than 180 degrees, causing a closed-loop obstruction that can lead to incarceration and strangulation
Hiatal Hernia
Type 1 & 2 describe and name.
Which is a higher risk for volvulus
What is the major concern for type 1
Type 1 (Sliding): Less serious
Type 2 - 4 (paraesophageal or rolling) more serious
Type 2 of risk for volvulus
Type 1 major concern Gerd
This mineral maybe lacking in paraesophageal or rolling hernias
Iron
Diagnostic for hiatal Hernia (3)
Barium, EGD, manometry HRM with esophageal pressure topography
Primary focus after HH repair is…
Prevent respitory complications
Elevate HOB 30°
Ambulate ASAP
Splinting when coughing
Most esophageal tumors are
Benign/ Malignant
Malignant
Diets high in nitrates can cause this problem
Esophageal Tumors
Esophageal Tumors can be detected with…
EGD with biopsy
PET scan
Photodynamic & porfimer therapy are examples of this type of care with esophageal Tumors
Palliative
After esophagectomy the risk increase with preop radiation.
After extubation assist with coughing/ deep breathing
How often?
Assess breath sounds, How Often?
Q 1-2 h
Why might a patient with chronic gastritis develop Pernicious anemia
Intrinsic factor lost
Needed for B12 absorption
Dyspepsia is the medical term for …
indigestion
Melena & Hematemesis are S/S of this acute disease
Gastritis
Peptic ulcer disease (PUD) is…
discontinuation in the inner lining of the gastrointestinal (GI) tract because of gastric acid secretion or pepsin
Gastritis/ PUD drug therapy
Magnesium/ Aluminum hydroxide
Assess for CKD / HF
Action
Increases Ph of gastric contents
Gastritis/ PUD drug therapy
Famotide
Nizatidine
Action
Lower gastric acid by blocking histamine
Gastritis/ PUD drug therapy
Sucralfate
Bismuth subsalicylate
Action / Precaution
Mucosal Barrier fortifiers
Don’t give with Aspirin
Because it is an Aspirin
PPI (prazole) supress gastric acid secretions
Precaución
Assess for this body system impairment
Don’t crush
Liver impairment
Prostaglandin analogs are not common
They lower gastric acid secretions & stimulate mucosal protection
Misoprostol
When are they given?
Avoid giving with which medication
Don’t give them to this type of patient
To clients receiving NSAIDS
Avoid magnesium-containing antacids
Not for pregant
Peptic Ulcer Disease is caused by H. Pylori or….
Long term NSAID use
Most serious complications of PUD
Hemorrhage
Rigid board-like abdomen with rebound tenderness and pain = peritonitis
This is a common symptom with…
PUD PEPTIC ULCER DISEASE
Robinul Injection (glycopyrrolate) is
This type of medication
Used to treat…
an anticholinergic
conditions such as peptic ulcers that involve excessive stomach acid production
Versed is which type of medication
Benzodiazepine
midazolam
Stomach is located in this quadrant
LUQ
Pancreas is located…
Behind stomach LUQ
Liver located in this quadrant
RUQ
Gall bladder is located
Behind liver RUQ
Lower right quadrant pain is associated with …
Appendix
If area of pain is noted this area is examined first
True or False
False
It is examined last
List physical assessment for GI
Inspection
Ausculation
Percussion
Palpation
Ausculation is performed with this side of the stethoscope _____
Because bowel sounds are ____ pitched
Diaphragm
High pitched
Timing of bowel sound intervals
Every 5 - 15 secs
5 - 30 per minute
Increased bowel sounds (aka) ____ is heard in patients with diarrhea
Borborygmus
____ is done by APN to determine size of solid organs
Percussion
Most often cause of anemia
GI bleed
Increased AST, ALT, PT all indicate this problem
Liver disorder
Elevations in amylase & lipase may indicate….
ACUTE Pancreatitis
Elevated serum ammonia may indicate that ammonia isn’t being converted to Amino acids or Urea
What organ is damaged
Liver
Possible Problem
Decreased Calcium <9
Malabsorption
Kidney failure
Acute Pancreatitis
Possible Problem
Decreased K <3.5
Vomiting
GI suction
Diarrhea
Possible Problem
Albumin <3.5
Hepatic disease
Possible Problem
Increased Bilirubin >1
Hemolysis
Biliary obstruction
Liver damage
Possible Problem
Ammonia >80
Hepatic disease
Cirrhosis
Possible Problem
Cholesterol
Both increase/ decrease
200 normal
Increase >200 pancreas
Decreasec<200 liver cell damage
Urine test look for (2)
Increased amylase = Acute Pancreatitis
Urobilinogen = hepatic / Biliary obstruction
How often gFOBT / FIT test
Yearly
Foods to avoid before guaiac test
Raw fruit and vegetables/ red meat
More reliable gFOBT or FIT test
FIT
Stool cytotoxic assay and culture can be used to find these types of problems
Parasites
C diff
Better more reliable choice
Cytotoxic assay or stool culture
Cytotoxic assay
Quicker
Enzyme- linked immunosorbentnl assay (ELISA) is used for…
C. Diff
Plain film of the abdomen is….
First X ray study used for GI problems
Sigmoidoscopy every ___ years
Colonoscopy every ___ years
5
10
CT scan with contrast medium
Ask for these allergies
NPO
Iodine / Shellfish
NPO 4 hrs prior
Is ibuprofen an NSAID
Yes
Before an EGD a patient is NPO 6 - 8 Hrs.
May they take their HTN meds in the AM?
Yeppers
Types of meds to avoid before EGD
NSAIDS / Anticoagulant
During EGD, RR is <10 nurses intervention
Sternal Rub
ERCP is used for…
Detecting & remove obstruction in liver, gallbladder, bile ducts, pancreas
Sclerotherapy is used to…
Stop Bleeding
Start colonoscopy at which age
50
Every 10 years colonoscopy
Why would atropine be used during a colonoscopy
To raise heart rate
Resulting from vagal response
Post op priority for EGD
Prevent aspiration
Thyroxine-binding prealbumin (PAB) is used for…
Normal range
A plasma protein
Nutritional deficiency
15 - 36 mg/dL
150 - 360 mg/L
Cholesterol below is an indication of malnutrition
<160
Does lymphocyte numbers vary with malnutrition
Yes
Below 1500/mm³ = malnutrition
Imbalanced nutrition: Less than body requirements related to inability to ingest or digest food or absorb nutrients
Is the priority nursing diagnosis for malnutrition
T or F
True
Edentulous means…
Toothless
Medical nutrition supplements MNS ____ is used for diabetic patent
Glucerna
Hemodynamic compromise:
Peritonitis, sever / acute pancreatitis, intestinal blockage, intractable vomit/ diarrhea, paralytic illeus
TEN: Total entrrnal nutrition is prescribed
T ir F
False
Check residual stomach content
How often
4 - 6 hrs
Blood urea nitrogen, serum electrolytes, hemacrit, prealbumin & glucose
Should be monitored during this type of feeding
Eternal
Diarrhea may occur when a (hypo/hyper) osmolar enternal preparation is delivered too quickly
Hyper
Most common electrolyte complications with eternal feedings
Hyperkalemia/ hyponatremia
Parental feeding are at risk for this fluid imbalance
Leading to this
Dehydration
Due to hyperosmolar fluid
Iron can cause
Diarrhea or Constipation
Constipation
A subtraction of 500 calories weekly will produce this much weight loss
1 lb weekly
BMI of
Or
BMI with co-morbidities
Is an indication for drug therapy
30
27
Orlistat (Xenical)
Are used for
How?
Treatment of obesity
Lipase inhibitor
Lorcaserin (Belviq)
Is an anti obesity drug
How does it work?
Activate serotonin 2C receptor
Decrease appetite
Anorectic drugs should not be taken by patients with which disease
HTN, Heart Disease, Hyperthyroidism
Worsens symptoms
Primary role of nurse in bariatric surgery
Reinforce health teachings in prep for surgery
LSG weight loss surgery described
The Ghrelin secreting portion of stomach removed
Less effective long term than Restrictive Surgery
Most common Malabsorption surgery
Roux-en-Y gastric bypass
After weight loss surgery monitor for
Back,shoulder,ab pain
Restlessness
Tachycardia/ oliguria
S/S of…
Anastomic leaks
Serious