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oral hygiene for patients with stomatitis
use soft bristled tooth brush or disposable form swabs to stimulate gums and clean the oral cavity
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when rinsing the mouth what should and should not be used
- should use solution
- NOT commercial mouth wash
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how often should oral mouth care be done for patients with stomatitis
every 2 hours and twice during the night
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key features of oral caner
- bleeding from the mouth
- poor appetite
- difficulty chewing
- difficulty swallowing
- poor nutritional status and weight loss
- thick or absent saliva
- painless oral lesion that is red, raised or eroded
- thickening or lump in cheek
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what is the definite method of diagnosing oral cancer
- biopsy
- physician obtains needle biopsy specimen of the abnormal tissue to assess for malignant or premalignant changes
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the postoperative care after radical neck disection
what position should patient be placed in and why?
- fowlers or semi fowlers
- elevate the head of the bed to assist in decreasing edema by gravity
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what is the most accurate method to diagnose GERD?
24 hour Ambulatory esophageal pH monitoring
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nonsurgical management for GERD
Lifestyle Changes
- elevate the Head of the bed 6 inches for sleep
- Sleep on the right side-lying position
- stop smoking and alcohol
- wear nonbinding clothing
- refrain from lifting heavy objects, straining or working in a bent over position
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what is the main treatment for GERD
Proton Pump Inhibitors
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what do Protons Pump Inhibitors do?
provide long acting inhibition of gastric acid secretion
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what do antacids do?
elevate the pH level of the gastric contents
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what do Histamine receptor antagonist do?
decrease acid production
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what do Prokinetic drugs do?
increase gastric emptying and improve lower esophageal sphincter pressure and esophageal peristalsis
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cause of gastritis
- H Pylori
- Escherichia coli
- other causes: long term NSAID use, corticosteroids, ETOH, radiation, stress
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what is the gold standard for diagnosing gastritis?
EGD via endoscope with biopsy
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what is the major diagnostic test for diagnosing PUD?
EGD (esophagogastroduodenoscopy)
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describe Gastric Ulcer Pain
gastric ulcer occurs in the upper epigastrium with localization to the left of the midline and is aggravated by food
(Quick Onset)
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Describe Duodenal Ulcer Pain
Duodenal ulcer pain is usually located to the right of the epigastrium
Occurs 90 mins to 3 hours after eating and often awakens patient at night
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what is the gold standard for surgical management of GERD?
Laparoscopic Nissen Fundoplication (LNF)
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what is the role of the nurse regarding GERD?
patient and family education
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discuss the pathology of GERD
- the most common upper GI disorder
- Reflux/backflow of the GI contents into the esophagus
- produces symptoms by exposing the esophageal mucosa to the irritating effects of gastric contents which results in inflammation
- the cause is the esophageal sphincter relaxes allowing the contents to come up
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clinical manifestations of GERD
- Dyspepsia-heartburn
- regurgitation-backward flow
- eructation- belching
- flatulence-gas
- dysphagia- difficulty swallowing
- odynophagia- painful swallowing
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what are the 3 major drug therapies for GERD
- Antacids-increase gastric pH by deactivating pepsin, short action length
- Histamine receptor antagonist (histamine blockers)-decrease acid
- Proton Pump Inhibitors-long acting, inhibition of gastric acid secretion
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what are the key features of s hiatal hernia?
- heartburn
- regurgitation
- chest pain
- dysphagia
- belching
- fullness after eating
- breathlessness after eating
- feeling of suffocation
- chest pain that mimics angina
- worsening of manifestations in recumbent position
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what is the most specific diagnostic test for identifying hiatal hernia
a barium swallow with fluoroscopy
sometimes a sliding hiatal hernia cannot be seen so an EGD is done
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nonsurgical treatments for hiatal hernia
- drug therapy
- nutritional therapy
- lifestyle changes
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