NUR 2392 MULTIDIMENSIONAL CARE II EXAM 3 BLUEPRINT

Exam 3 Blueprint Gastrointestinal System • Esophageal disorders (Assessment, S/S, Interventions) • Tumors-interventions: semisoft and thickened liquids, supplements, surgery • GERD ▪ Contributing Factors Caffeine, ...

Exam 3 Blueprint 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) NUR 2392 Multidimensional Care II ALL THE BEST • 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 ▪ 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 obstruction- Metabolic acidosis, Peritonitis, Strangulated obstruction ALL THE BEST • 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: Metam