Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
106 Cards in this Set
- Front
- Back
|
Oral cancer is aka?
|
Oropharyngeal cancer
|
|
|
What are some common sites for oropharyngeal cancer?
|
Lips
Tongue Floor of mouth Buccal muscosa Palates Pharnygeal walls Tonsils |
|
|
What are some predisposing factors of oral cancer?
|
Tobacco
Alcohol Poor dental care HPV Sun-lips |
|
|
Treatment measures for oral cancer include...
|
Surgery
Chemo Radiation |
|
|
What is the cause of esophageal cancer?
|
Unknown
|
|
|
What are some risk factors for esophageal cancer?
|
Smoking
Excessive alcohol intake Barrett's esophagus Diet low in fruits and vegetables Achalasia |
|
|
What is a condition in which there is a delayed emptying into lower esophagus?
|
Achalasia
|
|
|
What are some clinical mainfestations of esophageal cancer?
|
Symptoms onset is late relative to tumor growth
Progressive dysphaiga Pain Weight loss Regurgitation of blood-flecked esophageal contents |
|
|
Diagnostic studies for esophageal cancer include...
|
Endoscopy with biopsy for definitive diagnosis
Barium swallow CT and MRI to assess the extent of disease Bronchoscopy- to detect malignant involvement in the lung. |
|
|
In esophageal cancer majority of tumors are located...
|
In the middle and lower portion of esophagus
|
|
|
What is the main function of the GI?
|
To supply nutrients to the body cells
|
|
|
The upper GI is AKA...
|
The digestive system
|
|
|
What parts of the body are included in the GI?
|
Mouth
Esophagus Stomach Small intestines Large intestines Rectum Anus |
|
|
What organs are associated with the GI?
|
Liver
Gallbladder Pancreas |
|
|
What is the process by which the body uses food for energy, growth, and maintenance and repair of body tissues?
|
Nutrition
|
|
|
What is a deficit, excess, or imbalance of the essential components of a balanced diet?
|
Malnutrition
|
|
|
What is a state of poor nourishment as a result from inadequate diet or diseases that interfere with normal appetitie and assimilation of ingested food?
|
Undernutrition
|
|
|
What is ingestion of more food than is required for body needs?
|
Overnutrition
|
|
|
What is the normal lab value for albumin?
|
3.8-4.5 g/dl
|
|
|
What is the normal lab value for prealbumin?
|
20 mg/dl
|
|
|
What is the normal lab value for Serum transferrin?
|
215-380 mg/dl
|
|
|
What is the normal lab value for Protein?
|
6-8 g/dl
|
|
|
What is the normal lab value for BUN?
|
10-30 mg/dl
|
|
|
What is the normal lab value for Creatinine?
|
0.5-1.5 mg/dl
|
|
|
What is the normal lab value for Hemaglobin?
|
12-18
|
|
|
What is the normal lab value for hematocrit?
|
38-54%
|
|
|
What are some early clinical manifestations of oral cancer?
|
Leukoplakia
Erythroplakia Ulceration Sore that bleeds easily and never heals Rough area felt with the tongue |
|
|
What are some late clinical manifestations of oral cancer?
|
Pain
Dysphagia Difficulty moving the jaw |
|
|
What is the most definitive diagnostic study for oral cancer?
|
BIOPSY
|
|
|
What are some nursing managements for a oral cancer?
|
Teaching and prevention is key
Stop smoking Oral hygeine and dental care Adequate nutritional intake to promote healing Pain medication |
|
|
Barret's esophagus is considered a...
|
Premalignant condition-monitor closely
|
|
|
What are some nursing managements/interventions for esophagel cancer?
|
Nutritional needs-High calorie/protein before surgery
Oral care Prevention of respiratory problems Stable vitals,LOC,pain 15-30CC/ hour fluids b/c we dont want to distend (after surgery) |
|
|
What position should a patient with esophagel cancer be in after surgery?
|
Semi-fowlers to prevent refulx or aspiration. Upright position should be maintain for at least 2 hours after eating.
|
|
|
What are some surgical procedures done for esophagel cancer?
|
Esophagectomy
Esophagogastrostomy Esophagoenterostomy Chemo/radiation may be done |
|
|
What is a Esophagectomy?
|
Removal of part or all of the Esophagus.
Use of dacrom graph to replace resected part |
|
|
What is a Esophagogastrostomy?
|
Resection of a portion of Esophagus and anastomosis of remaining portion to stomach.
|
|
|
What is a Esophagoenterostomy
|
resection of a portion of Esophagus and anastomosis of segment of colon to remaining portion.
May be open or laparoscopic |
|
|
What is any clinically significant symptomatic condition secondary to reflux of gastric contents into the lower esophagus?
|
GERD
|
|
|
What is the most common upper GI problem?
|
GERD
|
|
|
What are some predisposing factors of GERD?
|
Hiatal hernia
Impaired esophageal motility Delayed gastric empyting Incompentent LES |
|
|
What are some clinical manifestations of GERD?
|
Pyrosis (heartburn)
Dyspepsia Hypersalivation Regurgitation Hoarseness, sore throat, globus sensation (lump in throat), and choking |
|
|
What are some complications of GERD?
|
Esophagitis
Esophageal Stricture Barret’s Esophagus |
|
|
What is esophagitis?
|
Inflammation of the esophagus.-Mallory-weiss tear
|
|
|
A repeated exposure to this complication of GERD may cause scar tissue formation and decreased distensibility,leading to dysphagia?
|
Esophageal Stricture
|
|
|
What is herniation of a portion of the stomach into the esophagus through an opening in the diaphragm?
|
Hiatal hernia
|
|
|
What are some predisposing factors of a hiatal hernia?
|
Structural changes
Factors that increase intraabdominal pressure (obesity, pregnancy, ascites, tumors, tight girdles, heavy lifting on continuous basis) Increased age Poor nutrition Forced recumbent position |
|
|
What are some clinical manifestations of a hiatal hernia?
|
Heartburn
Precipitating factors of pain: bending over, large meals, alcohol, smoking May complain of dysphagia |
|
|
What are some diagnosis studies for GERD and hiatal hernia?
|
Upper GI Endoscopy
Barium Swallow Motility studies pH monitoring |
|
|
What are some Collaborative care for GERD and hiatal hernia?
|
Lifestyle modifications
Nutritional Therapy Drug therapy Surgery Elevate HOB! |
|
|
What are some lifestyle modifications someone can do if they have GERD or a hiatal hernia?
|
Avoid factors that aggravate symptoms
No smoking No alcohol intake Foods that cause reflux and lower LES pressure: (chocolate, peppermint, coffee, tea) Meds that may affect LES, acid secretion, or gastric emptying |
|
|
What are some nutritional Therapy someone can do if the have GERD or a hiatal hernia?
|
Weight reduction to reduce intraabdominal pressure
Diet does not cause GERD, but foods can aggravate symptoms Avoid milk products, esp at bedtime, b/c milk increases gastric acid production Small frequent meals Avoid late meals and nocturnal eating Take fluids b/w meals rather than w/ meals Walk around after eating |
|
|
What are some Drug therapies someone can do if the have GERD or a hiatal hernia?
|
Antacids-should be taken 1 to 3 hours after meals and at bedtime
Acid Neutralizers: Gelusil, Maalox, Mylanta Antisecretory Agents- H2Blockers and PPIs –decrease the secretion of HCl acid by the stomach H2R Blockers: Tagamet, Pepcid, Axid PPIs: Nexium, Prevacid, Prilosec Cytoprotective drugs-antiulcer drug Gaviscon and Carafate Cholinergic Drugs -increase LES pressure Urecholine (bethanechol) |
|
|
What are Surgeries someone can do if the have GERD or a hiatal hernia?
|
Anti-reflux procedure
|
|
|
What is a condition characterized by erosion of the GI mucosa resulting from the digestive action of HCl acid and pepsin
|
Peptic Ulcer Disease
|
|
|
What kind of ulcer is superficial erosion and minimal inflammation (short duration and resolves quickly when the cause is identified and removed)?
|
Acute Ulcer
|
|
|
What kind of ulcer has a long duration, eroding through the muscular wall with the formation of fibrous tissue (4x as common as an acute ulcer)?
|
Chronic Ulcer
|
|
|
What are the two kinds of PUD?
|
PUD-Gastric
PUD- Duodenal |
|
|
What kind of peptic ulcer is more likely to result in hemorrhage, perforation, and obstruction?
|
Gastric ulcer
|
|
|
What kind of lesions does a Gastric ulcer have?
|
Superficial lesions
|
|
|
Where does perforation occur in gastric ulcers?
|
In the lesser curvature of the stomach
|
|
|
Where does perforation occur in duodenal ulcers?
|
In the begining of the duodenum
|
|
|
What kind of lesions does a duodenal ulcer have?
|
Penetrating lesions
|
|
|
What are some symptoms of a gastric ulcer?
|
Burning or gaseous pressure in back and upper abdomen
Pain 1-2 hours after meals N/V Weight loss |
|
|
What are some symptoms of duodenal ulcers?
|
Burning,cramping,pressurelike pain across mid-epigastrum and upper abdomen
Pain 2-4 hours after meals and in the middle of the night |
|
|
In a gastric ulcer what may precipitate pain?
|
Food
|
|
|
How does someone with a duodenal ulcer get relief of pain?
|
They eat
|
|
|
What kind of an enviornment does a peptic ulcer develop in?
|
Acidic
|
|
|
What is the stomach protected by?
|
A gastric mucosal barrier
|
|
|
What can the gastric mucosal barrier be destroyed by?
|
H. pylori
Asprin NSAIDS Steroids Alcohol Smoking |
|
|
What is the most common complication of PUD?
|
Hemorrhage
|
|
|
What are the 3 major complications of PUD?
|
Hemorrhage
Perforation Gastric outlet obstruction |
|
|
What is the most lethal complication/ high mortality of PUD?
|
Perforation
|
|
|
What are some nursing Care for a person with PUD complications?
|
NPO, NG suction, Bed rest
IV fluid replacement (Lactated ringers) Blood transfusions Possible emergency surgery |
|
|
What are some diagnostic testings for a person with PUD?
|
Endoscopy
Diagnostic tests to confirm h. pylori in breath, urine, blood, tissue |
|
|
What are some treatments of PUD?
|
Lifestyle modifications—smoking cessation and no alcohol intake
Dietary changes –avoid irritating foods and beverages; eat and drink fluids that do not cause any distress/ eliminate alcohol and caffiene containing products |
|
|
What are some medications used to treat PUD?
|
H2R Blockers
PPIs (Proton Pump Inhibitors) Antacids Antibiotics to treat H. pylori Anticholinergics Cytoprotective therapy |
|
|
Gastric cancer AKA?
|
Adenocarcinoma
|
|
|
What are some risk factors for gastric cancer?
|
Stomach carcinogens (aging, autoimmunity, repeated exposure to irritants such as smoke, bile, and antiinflammatory agents)
|
|
|
What are some signs and symptoms of gasrtic cancer?
|
Usually have s/s of anemia and PUD:
Pallor SOB Fatigue Burning pain Weight loss Dysphagia |
|
|
What are some complications of gastric cancer?
|
Dumping syndrome
Post-prandial hypoglycemia |
|
|
What is Dumping syndrome?
|
Sudden decrease in plasma volume (generalized weakness, sweating, palpitations, and dizziness may occur as well as abdominal cramping/urge to defecate)
Occurs about 15-30 minutes after eating |
|
|
What is Post-prandial hypoglycemia?
|
Variant of the dumping syndrome but occuring about 2 hours after the meal (symptoms include: sweating, weakness, mental confusion, palpitations, tachycardia, anxiety)
|
|
|
What are some Gastric Surgeries that are done for gastric cancer?
|
Vagotomy
Billroth I and Billroth II Pyloroplasty Antrectomy |
|
|
When there is bleeding from the arterial source what color is it and what does it indicate?
|
Bright red and it means it has not come in contact with stomach's acid secretion
|
|
|
What does "coffee ground" vomitus reveal about the blood?
|
That the blood and other contents have been in the stomach for a while
|
|
|
What is melena?
|
(black, tarry stool) indicates slow bleeding from an upper GI source
|
|
|
What is Hematemesis?
|
Blood in vomit
|
|
|
What are some treatments of a person with a GI bleeding?
|
Relxation
RBC may be given Strict I&O's Monitor H&H Maintain IV line |
|
|
For a person with a GI bleed you need to monitor there VS every...
|
15-30 minutes
|
|
|
What are major complications of malnutrition?
|
Delayed wound healing
Increased susceptibility to infections |
|
|
Obesity is classified by useing what scale?
|
BMI
|
|
|
What is a normal BMI?
|
18.5-24.9
|
|
|
What is a underweight BMI?
|
anything under 18.5
|
|
|
What is a overweight BMI?
|
25-29.9
|
|
|
What is an obese BMI?
|
30+
|
|
|
What is a morbidly obese BMI?
|
40+
|
|
|
What are some health risk associated with obesity?
|
Cardiovascular
Respiratory Diabetes Mellitus Musculoskeletal Gastrointestinal and Liver Cancer Psychosocial |
|
|
What are some ways to promote weight loss?
|
Nutritional therapy
Exercise Behavior modification Support groups Drug therapy Surgery |
|
|
What are some nutritional therapy one can do to loss weight?
|
Eat regularly, do not skip meals
Measure foods to determine the correct portion size Avoid concentrated sweets Reduce fat intake by baking, broiling, or steaming foods Maintain a regular exercise program for successful weight loss |
|
|
What is a surgery one can use to help loss weight?
|
Bariatric surgeries
|
|
|
What are some preop nessasitys for a Bariatric surgery?
|
Big BP cuff
Correct size bed in OR Enough team members to move patient |
|
|
What is done during postop care of a Bariatric surgery?
|
IV fluids then progressive oral intake of 15-30cc/hr
ROM Pain meds Wound care NG tube care |
|
|
How do you do care for a NG tube?
|
Do not irrigate NG tube w/o orders (indicated for esophageal surgies b/c of sutures or bleeding)
Be mindful of black marks (use them to make sure that the tube is not moving –b/c it could come out of the stomach and then aspiration is a big problem) Make sure suction is on (what is it set on? LIWS –Low intermittent wall suction) Examine amount and color each shift |
|
|
What are some other procedures done for weight loss?
|
Restrictive Surgeries
Malabsorptive Surgeries |
|
|
What is a Restrictive Surgery?
|
Bandings –reduce the size of the stomach
|
|
|
What is a Malabsorptive Surgery?
|
Bypass various lengths of small intestines so less food is absorbed
|
