1345 - Ingestion / Esophageal Disorders
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26 terms
Terms | Definitions |
|---|---|
 Stomatitis | - painful single or multiple ulceration (Canker sores) - inflammation & erosion of the protective lining of the mouth - painful & open areas at risk for bleeding & infection |
| S/S of Stomatitis | - Dry, painful mouth - open lacerations - difficulty w/ swallowing or eating - severe stomatitis can have edema which can potentially block airway |
| Primary Stomatitis | - most common - usually from herpes simplex |
| Secondary Stomatitis | caused by - cancer - HIV - viruses - bacteria - chemo - long term antibiotic use - yeast |
| Aphthous | noninfectious ulcer in the mouth - stomatitis |
| Oral Candidiasis | - yeast infection - white plaque-like lesions - tongue, palate, pharynx, buccal mucosa - if patches are wiped away, underlying areas red & sore - can be painful, dry, or hot |
| Periodontal Disease | - Disorders of the gums - Inflammation causes destruction of underlying tissues leading to loose teeth |
| Oral Cavity Premalignant Tumors | Leukoplakia - white plaque / can't scrap it off Erythoplakia - red velvety patch / early sign for squamous cell cancer |
| Oral Cavity Malignant Tumors | Squamous Cell Carcinoma (chemical irritation) Basal Cell Carcinoma (purple lesion on lips / sun) Kaposi's Sarcoma (lesions in blood vessels / purple nodes or plaques / HIV) - usually not painful - associated w/ alcohol & tobacco use |
| Oral Cavity Malignant Tumor Interventions | - use of alcohol or tobacco - oral hygiene habits - exposure to sun - difficulty swallowing - pain - oral cavity inspection - surgical tx - post-op nursing care (trach tube) |
| Radical neck dissection | - all tissue under skin from jaw to clavicle - anterior border of trapezius to the midline - cervical lymph nodes - sternocleidomastoid muscle - spinal accessory nerve - resect the jugular vein |
| Acute Sialadenitis | - inflammation of a salivary gland - could have stones in salivary glands - secretions decrease, bacteria invade gland & multiply - caused by gland inactivity r/t diuretics, prolonged NG tube intubation, lack of PO intake * promote secretions & frequent hydration |
| Postirraditation Sialadenitis | - salivary glands sensitive to radiation - can cause xerostomia (severe dry mouth) associated w/ thyroid cancer * frequent water, mouth care, salivary substitutes |
| Achalasia | - disorder characterized by progressively increasing dysphagia - 20's & 30's - unknown cause - impaired motility of the lower 2/3 of the esophagus - regurgitation of undigested food eaten many hours earlier & large amounts of mucous |
| Achalasia management | - esophageal dialation - Barium swallow - endoscopy / EGD - calcium channel blockers or nitrates - small frequent feedings - avoid hot, spicy, iced foods, alcohol, tobacco - chew foods thoroughly - sleep w/ HOB elevated |
| Diffuse Esophageal Spasm | - abnormal contractions of the muscles in the esophagus - does not move food effectively to the stomach - difficulty swallowing or pain - pain in chest or upper abdomen - pain can radiate to jaw, arms, or neck * Tx: Nitroglycerine, Calcium Channel Blockers, antidepressant |
| GERD | - results from back flow of gastric contents into esophagus - relaxation of the LES allowing reflux - pain usually occurs after meals & is relieved w/ antacids or fluids |
| S/S of Gerd | - heartburn - odynophagia (painful swallowing) - dysphagia - acid regurgitation - eructation (burping) |
| Nissen Fundoplication | - surgery for GERD - suture fundus around esophagus complications: dysphagia epigastric fullness bloating hyperactive bowel sounds |
| Meds for GERD | Antacids / Histamine receptor antagonists / cholinergics / Prokinetic agents / PPI AVOID: Anticholinergics / Calcium Channel Blockers / Theophylline / Valium |
| Hiatal Hernia | - cardiac sphincter is enlarged - part of stomach passes into the thoracic cavity - related to muscle weakness in the esophageal hiatus |
| Causes of Hiatal Hernia | - aging - congenital muscle weakness - trauma - surgery - obesity - pregnancy - ascites |
| Diverticula | - saclike outpouchings in 1 or more layers of the esophagus - food gets trapped in a diverticulum & can later be regurgitated |
| S/S of Diverticula | - vomiting blood - chest pain - ↑ temp - Sub Q emphysema - dysphagia - burping - halitosis - coughing - sour taste in mouth - regurgitation of undigested food |
| Esophageal Neoplasms | - usually squamous cell carcinoma or adenocarcinoma - links to smoking, alcohol, hot food & drinks, nutritional deficiencies - expand locally & very rapidly w/ early spread to lymph nodes - outcome poor - usually tx is palliative |
| S/S of Esophageal Neoplasms | - dysphagia - weight loss - odynophagia (painful swallowing) - food goes into lungs thru holes |
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