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23 Cards in this Set
- Front
- Back
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Abnormalities of the Oral Cavity
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Xerostomia: dry mouth caused by radiation, chemo, medications
Altered Taste: From meds (oncoogy pt.), tongue disease |
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What is Dysphagia?
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Inability to swallow:
-Stroke -Trauma: Head injuries -Neuromuscular Disease: Parkinson's, MS, Alzheimers -Disorders of LES: leads to esophogeal erosion |
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LES Disorders
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*Achalasia: Lose inhibitory neurotransmitters; can lead to immune disease b/c LES can close
*Esophogeal stricture *Esophogeal cancer *GERD: Incompetence of LES; decreases LES pressure |
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Medical and Surgical Management of Esophogeal diseases
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*Medications:
-Proton Pump Inhibitors: Prilosec, Prevacid -H-2 Receptor Antagonists: Zantac, Pepcid AC -Antacids: Alka Seltzer, Maalox -Prokinetic Agents: Reglan -Foaming agents: Gaviscon *Surgery: -Fundoplication: Upper stomach wraps around the sphincter |
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Esophogeal Disease:
Sign and Symptoms |
Chewing/swallowing problems, taste alteration, NVD, postprandial pain
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Esophogeal Disease:
Anthropometry, Lab values |
-Ht., wt., BMI, DBW
-PE: decubitis, ascites, edema Lab: Albumin, Prealbumin, Na, CO2, Creat, K, BUN, Glu |
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Esophogeal Disease:
Diet Order |
Soft post-surgical, no meals 2 h. before bed
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Esophogeal Disease:
Patient Instructions |
Avoid: Lying down after meals, smoking, ETOH, coffee, peppermint, acidic/spicy foods
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Esophogeal Disease:
Problem |
-Increased nutrient needs
-Improper food choices -Difficulty swallowing |
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Esophogeal Disease:
Goal |
-Meet >75% nutrient requirements
-Avoid complications related to diet -Optimize nutrition |
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Esophogeal Disease:
Evaluation |
-Monitor Prealbumin (26 mg/dL)
-Monitor wt. (every 3-5 days) -Monitor po intake (no pain, 75% diet order) If condition worsens, refer to Speech path, NPO |
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Stomach Disorders
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-Nausea and Vomiting
-Gastritis: due to infections, food poisoning, ETOH, NSAIDS -PUD -Dehydration -Gastroparesis -Gastric cancer |
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Dehydration symptoms and supplementation
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Symptoms:
-Headache, wt. change, tachycardia, dry lips, thirst Supplementation: -Enlive, Resource, Gatorade 50:50 water, Pedialyte |
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Stomach Disorders:
Common Problems and Supplementation |
-B12, Pro, HCl can be affected
-Clears for 3-5 days 8 h s/p last vomit -When solids are introduced, start w. BRAT |
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PUD:
Etiology and Pathophysiology |
-Ulceration of gastric mucosa
*Caused by: -H. pylori: Attaches to mucus cells -NSAIDS -ETOH Abuse -Gastritis -Smoking -Stress -Radiation -Trauma |
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PUD:
Symptoms |
-Dyspepsia
-Epigastric pain -N/V -GI bleeding -Postprandial pain 2-3 h |
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PUD: Diagnosis
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Diagnose:
-Upper GI series- endoscopy, blood test -H. pylori stool antigen -Treated by triple therapy: 2 antibiotics for barrier protection for 7-14 days Proton pump inhibitors: Prilosec, Prevacid |
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PUD: Medications
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-Proton pump inhibitors: Prilosec, Prevacid
-H-2 Receptor antagonist: Zantac, Pepcid AC Antacids: Maalox Antibiotics: Amoxicillin, Gaviscon -GI Cocktail: Bismuth, Lidacane |
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PUD: MNT Note
Sign and Symptoms |
Diet Hx: Po intake, look for GI discomfort foods
GI Hx: appetite, taste acuity, NVDC, chewing/swallowing, GI discomfort -PE: decubitis |
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PUD: MNT Note
Anthropometry, Lab values + Nutrition Assessment and Diagnosis |
-Ht, wt
-Iron studies: serum, TIBC, Hct, Hgb -Na, Glu, Vitals, UA -30-35 kcal/kg BW |
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PUD: MNT Note
Diet Order, Supplementation, Pt. Instructions |
*Clears, Soft post-surgical
*Ensure, Boost *w-3 FA, w-6FA; decrease GI irritants; avoid eating 2 h. before bed |
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PUD: Nutrient Implications
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-Decreased nutrient intake
-Increased nutrient losses -Increased nutrient needs |
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Gastroparesis: Etiology and Pathophysiology
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*Delayed gastric emptying
*Damage to vagus nerve caused by glucose toxicity *Caused by: -Diabetes -Neuropathy- Parkinson's -Gastric surgery- complications causing bacterial overgrowth and bezoars(fiber balls) -Anorexia nervosa -Severe alcerations -Protractive vomiting *Fat and fiber should be avoided |
