Nursing of Adults

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Author:
hoving22
ID:
103190
Filename:
Nursing of Adults
Updated:
2011-09-20 22:05:46
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Test III
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Description:
Nutrition, GI,
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  1. generally results from infection by opportunistic viruses, fungi, or bacteria in pt's who are immunocomprimised
    secondary stomatitis
  2. foods such as coffee, potatoes, cheese, nuts, citrus fruits, and gluten may be causative factors
    stomatitis
  3. plays a large role in the formation of recurrent stomatitis
    malnutrition
  4. Interventions for stomatitis
    • health promotion through careful oral hygiene and food selection
    • soft bristled tooth brush
    • rinse mouth every 2-3 hrs with Bicarb
    • avoid alcohol rinse
  5. protrusion of the stomach through the esophogeal hiatus of the diaphragm into the chest
    hiatal hernia
  6. major concern is the development of esophageal reflex.

    result of weakening diaphragm

    occurs when esophagogastric junction and a portion of the fundus of the stomach slide upward through esophageal hiatus into chest
    sliding hernia
  7. risk for volvulus(twisting), obstruction, and strangulation are high

    fundus rolls into the thorax beside the esophagus
    paraesophageal (rolling) hernia
  8. Assessment of possible paraesophageal hernia
    ask about:

    • heartburn
    • regurgatation
    • pain
    • dysphagia
    • belching
    • worsening of symptoms after eating
  9. nonsurgical interventions of a hernia
    • drug therapy (antacids)
    • nutrition
    • lifestyle changes
    • avoid eating late at night
    • lose weight
  10. minimally invasive surgery commonly used for hiatal hernia repair
    laproscopic nissen funoplication
  11. NG inserted for several days
    deep breathing is important but painful postop
    teaching for LNF
  12. normal drainage for ng tube postop LNF

    frequency of assessment post op
    • dark brown with old blood
    • should become yellow/green within 8 hrs post op

    every 4-8 hrs
  13. Eating and diet post op for LNF
    clear fluids may begin when peristalsis is reestablished

    near normal diet within 4-6 weeks

    stomach is smaller, so meals need to be so
  14. a chronic disorder requiring ongoing management
    GERD
  15. surgical treatment for GERD
    LNF
  16. act by elevating the pH level of gastric contents, deactivating pepsin in pt's with GERD

    what do you teach about a pt taking this around meal time?
    Antacids

    • 1 hr ac
    • 2-3 hr bc
  17. decrease acid production in pt's with GERD
    histamine receptor antagonists
  18. can interfere with calcium absorption and protein digestion and therefore reduce available calcium

    provide effective, long-acting inhibition of gastric acid secretion
    Proton pump inhibitors (PPI's)
  19. Diet teaching for a pt with GERD
    avoid foods that decrease LES such as:

    • chocolate
    • alcohol and tobacco
    • fatty foods
    • caffeine
    • pop
    • spicy and acidic foods
  20. PT teaching for GERD
    large meals increase the V and P in stomach, delaying gastric emptying

    many small meals rather than few big

    no food for at least 3 hrs before bed
  21. nursing diagnosis of GERD
    • acute pain
    • risk for aspiration due to inadequate LES function
    • impaired swallowing
  22. lifestyle changes for a pt with GERD
    • elevate head of bed when sleeping
    • sleep in left lateral decubitus position
    • stop smoking and drinking
    • reduce weight
    • refrain from heavy lifting

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