Gastrointestinal System Esophageal disorders (Assessment, S/S, Interventions) Tumors-interventions: semisoft and thickened liquids, supplements, surgery GERD Contributing Factors ... Caffeine, chocolate, citrus fruits, tomatoes, peppermint, alcohol, smoking, pregnancy, obesity, bending forward, lying down after eating, NG tube placement, calcium channel blockers, nitrates, anticholinergic drugs Risks Assessment- dyspepsia, regurgitation, burping, farting, bloating, crackles, hoarseness, wheezing at night, chronic cough Interventions- nutrition therapy, lifestyle changes, chronic disorder, ongoing management Hiatal Hernia Sliding vs Rolling- rolling clearly visible, sliding observed with position changes Sliding- development esophageal reflux, heartburn and chest pain, regurgitation, dysphagia and belching Rolling- No reflux, feelings after eating: breathlessness, chest pain, worse when recumbent, fullness Assessment Interventions-avoid late night eating, restricted diet, exercise, elevated head of bed, remain upright after eating, no tight clothes Surgical care- soft diet, antireflux meds, report signs of infection o Oral Cavity Disorders (Assessment, S/S, Interventions) Stomatitis-inflammation in oral cavity Assess for lesions/cracking lesions on pharynx may indicate extension down into esophagus, may need swallow studies Rinse with sodium bicarb solution every 2-3 hours, cool liquids, high protein & vitamin C Oral Tumors (Leukoplakia vs Erythroplakia) Leukoplakia- (smoker’s patch) thickened white patches, slightly raised and rounded, can’t be removed by scraping Erythroplakia- red lesions, precancerous Oral Cancer- Mucosal erythroplasia earliest sign Red, raised, eroded areas Lesion not healed within 2 weeks o Basal cell carcinoma Asymptomatic Resembles a scab Primarily on lips Karposi’s sarcoma Malignant lesion in blood vessels Raised, purple nodule/plaque Usually painless NUR2392, MDCII – Examination Blue Print – Exam 3 On hard palate Salivary Gland Disorders Sialadenitis- inflammation of gland, bacterial or viral, decrease saliva production Interventions: hydration, warm compress, massage gland, saliva substitute Tumors- facial weakness or paralysis, assess facial nerve (CN VII) by wrinkling nose and brows, pucker lips, puff out cheeks, smile o Stomach Disorders Gastritis (Risks, Assessment, S/S, Intervention) Treatment: Medications & Education Peptic Ulcer Disease (Etiology & Complications) Medication Management Interventions Upper GI Bleed (Risks, Assessment, S/S, Intervention) Gastric Cancer (Assessment, S/S, Intervention) Dumping Syndrome (Assessment, S/S, Intervention, Education) Non-Inflammatory Disorders o Etiology, Assessment S/S, Interventions, & Management Obstruction & Fecal Impaction S/S- Nausea & Vomiting, Cramping, Abdomen distention, Pain, Obstipation, Long history of constipation, Fever, Tachycardia Complications: High obstruction- Metabolic alkalosis, Low obstructionMetabolic acidosis, Peritonitis, Strangulated obstruction Interventions: Monitor Vital Signs Assess abdomen (BS, distention, flatus) Monitor fluid and electrolyte status Pain management Manage nasogastric tube Drainage Patency Placement Irrigate Mouth and nares care Semi-Fowlers position Preventing: Eat high-fiber foods; raw fruits & veggies, whole-grain Drink adequate amounts of fluids, esp water No routine laxatives Encourage regular exercise – walking daily Natural foods to stimulate peristalsis – warm beverages, prune juice Bulk-forming foods: Metamucil Check stool for amount & frequency Sit on toilet or commode rather than bed pan for elimination Polyps- Small mucosal growths attached to surface of intestines [Show More]
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