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83 Cards in this Set
- Front
- Back
What causes tooth decay?
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bacteria on fermentable carbohydrates, which produces acids that dissolve the tooth enamel
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What is preventable hygiene?
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brushing teeth 2x day, flossing, mouth rinse, 2x year visit to dentist, avoid alcohol, tobacco, sugar, starch, replace toothbrush every 2 months
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What medications can cause dry mouth and increase risk of infection?
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diuretics, antihypertensives, antidepressants
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What is a periapical abscess?
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collection of pus in the apical dental periosteum and tissue surrounding tooth
-oral surgury |
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What is malocclusion?
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misalignment of teeth when mouth is closed, can cause difficulty in cleaning
-orthodontist |
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What is actinic cheilitis?
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premalignant squamous, scaling, crusty, fissure of lips
-from sun exposure |
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What is herpes simplix 1?
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opportunitist infection, contagious, painful vessicle that may rupture
-acyclovir |
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What is chancre?
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reddend, crusted lesion from syphillis
-antibiotics |
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What is contact dermatitis?
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red rash, allergric rx to lipstick
-corticosteroids |
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What is leukoplakia?
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white patches, painless, may progress to cancer
-eliminate tobacco |
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What is hairy leukoplakia?
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white patches with rough hair-like protections, viral, HIV
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what is lichen planus?
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white papules that are ulcerated and painful, may become malignant
-corticosteroids |
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What is candidiasis?
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(thrush) cheesy white plaque, fungus
-antifungul |
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What is aphthous stomatitis?
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(canker sore) shallow white ulcer, stress
-antibiodics or corticosteriods is severe |
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What is nicotine stomatitis
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(smoker's patch) red that turns to creamy thick white mucous, chronic tobacco use
-stop smoking |
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What is krythoplakia?
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red patch, nonspecific inflammation
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What is kaposi's sarcoma?
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red, purple, blue lesion from HIV infection
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what is stomatitis?
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redness and edema, painful ulceration, from chemo, radiation therapy or severe drug allergy
-oral hygiene, antibiotic, antiinflamm, anesthetic |
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What is gingivitis?
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painful, swollen gums, bleeding gums
-oral hygiene |
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What is necrotizing gingivitis?
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(trench mouth) gray white ulcerations, bleedin gums, foul breath, painful swallowing from poor hygiene, bacterial infection, stress
-oral hygiene, irrigation |
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What is herpetic gingivostamatitis?
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burning vessicles that form shallow ulcers, from herpes simplex virus, immunosuppression
-topical analgesic, irrigation, antiviral |
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What is periodontitis?
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bleeding, infection, gum recession from poor oral hygiene and nutrition
-oral hygiene, dentist |
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How are temporomandibular disorders categorized?
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-myofacial pain
-internal derangement of jaw -degenerative joint disease |
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How are temporomandibular disorders treated?
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stress management, ROM ex, NSAIDS, opioids, muscle relax, antidepressants
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What glands consist of the salivary glands?
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parotid, submandibular, sublingual, buccal glands
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How much saliva is produced per day and what is its function?
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1200 mL/day
lubrication, protection against bacteria, digestion |
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What is parotitis?
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inflammation of parotid gland or other salivary gland
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What often causes parotitis?
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-mumps (epidemic parotitis) which is viral
-staphylococcus aureas -dehydration or meds |
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What are the s/s of parotitis and the treatment?
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sudden fever, gland swelling, pain in ear, skin turns red and shiny
-treatment is antibiotics, oral hygiene, nutrition, discont meds, analgesics, maybe parotidectomy to drain gland |
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What is sialadenitis and what causes it?
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inflammation of salivary glands
-dehydration, stress, radiation, malnutrition, salivary gland calculi, poor oral hygiene -streptococcus viridans, s. aureas, MRSA, pneumococci |
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What are the s/s of sialadenitis and the treatment?
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pain, swelling, purulent discharge
-antibiotics, massage, hydration, warm compresses corticosteriods, surgical drainage |
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What is sialolithiasis (salivary calculus)?
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calcium phosphate build up in submandibular gland duct
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What are the s/s and treatment of sialolithiasis?
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no symptoms unless infection, local, colicky pain, gush of saliva
-may spontaneously pass, extracted, lithotripsy (shock waves), surgery |
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Where due neoplasms occur in salivary glands and how are they treated?
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parotid gland
-radiation, excision, dissection, chemo *must be careful not to damage 7th cranial nerve |
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Oral cancer is often associated with what?
What type of cancer is it and where is it most oftenly found? |
alcohol, tobacoo, chronic irritation, dietary deficiency
-squamous cell -common on lips, tongue, floor of mouth |
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What are the s/s of oral cancer?
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painless sore that will not heal (2 weeks), hardened with raised edges, may progress to tenderness, difficulty swallowing, speaking, coughing up blood, enlarged cervical lymph nodes
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What is the diagnostic test and medical management of oral cancer?
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biopsy
surgical resection, radiation, chem, reconstruction from forearm |
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If a person cannot brush or floss what can they do instead?
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baking soda and water
hydrogen peroxide and water or saline and water rinse |
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What is xerostomia, what causes it and how can you manage it?
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-dryness of the mouth
-radiation, surgery, psychopharm meds, HIV, those that cannot close their mouths -minimize alcohol, tobacco, dry irritating foods, use humidifier while sleeping, synthetic saliva |
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What is stomatitis (mucositis), what causes it and how can it be managed?
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-inflamm and breakdown of oral mucosa
-side effect of chemo, radiation -teeth extraction, fluoride treatments |
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What is leukopenia, what can cause it, how can it be managed with regards to oral cancer?
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-decreased white blood cells (increase risk for infection)
-radiation, chem, AIDS, HIV, meds, malnutrition, diabetes -after surgery freq temp checks, strict aseptic tech, skin protection |
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What is included in the malignancies of the head and neck?
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oral cavity, oropharynx, hypopharynx, nasopharynx, nasal cavity, paranasal sinus, larynx
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How are malignancies of the head and neck treated?
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radiation, chemo, surgery-radical neck dissection- removal of all cervical lymph nodes, removal of sternocleidomastoid muscle, interal jugular vein, spinal accessory muscle on one side of the neck
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What are potential complications of neck dissection surgery?
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altered respiration, wound infection, hemorrhage, shoulder drop
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To help maintain airway what should be done?
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fowler's position- facilitates breathing, increases lymphatic and venous drainage
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After neck dissection what can cause hemorrhaging, what are the s/s, and what are some nursing interventions?
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-rupture of carotid artery
-tachycardia, tachypnea, hypotension, high epigastric pain (rupture) -avoid valsalva, elevate HOB, calm environment |
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What is a chyle fistula and the treatment?
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milk like drainage from thorasic duct into thorasic cavity from damage of thorasic duct
-pressure dressing, diet of parental nutrition, med chain fatty acids, surgical intervention |
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What nerve damage could occur with neck dissection?
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lower face paralysis, superior laryngeal nerve- swallowing, speech problems
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Describe the anatomy of the esophagus.
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begins at base of pharynx, ends below diapham, mucus lined muscular tube that carries food from the mouth to the stomach
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What are the two esophageal sphincters?
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hypopharyngeal sphincter
gastroesophageal sphincter |
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What is achalasia?
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absent or ineffective peristalis of distal esophagus, with failure of esophageal sphincter to relax in response to swallowing
Narrowing of esophagus just above stomach results in increasing dilation of esophagus in upper chest |
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What are the s/s and secondary complications of achalasia?
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difficulty swallowing, regurgitation, chest pain, heartburn, discomfort of sensation of food sticking in lower esophagus
-aspiration of gastric contents |
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How is achalasia diagnosed and treated?
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-x-ray, barium swallow, CT, endoscopy
-eat slowly, drink while eating, botox injections, pneumatic dilation (stretching of esophagus), esophagomyotomy |
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What is diffuse spasm, the cause, s/s, diagnosis and treatment?
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-motor disorder of esophagus
-unknown cause -difficulty swallowing, pain on swallowing, chest pain -esophageal manometry -nitrates, calcium channel blockers, small freq meals, pneumatic dilation, esophagomyotomy, transhiatal esophagectomy |
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What is a hiatal hernia?
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upper stomach moves up into lower portion of thorax above diaphram
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What are the 2 types of hiatal hernias?
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Type I, sliding- upper stomach and gastroesophageal junction are displaced upward and slide in and out of thorax
Type II, paraesophageal- all or parts of the stomach pass through the diaphragm besides the esophagus |
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What are the s/s, diagnostic tests, and potential complications?
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-heartburn, regurgitation, dysphagia, asymptomatic, fullness after eating, chest pain
-x-ray, barium swallow, fluroscopy -hemorrhaging, obstruction, strangulation |
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What is the treatment for hiatal hernias?
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freq small meals, stay upright for 1 hour after eating, elevate HOB, surgery
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What is a diverticulum?
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outpouching of mucosa and submucosa that protrudes thru a weak portion of the musculature, can accure upper, mid or lower esophagus
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What is the most common type of diverticulum?
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Zenker's diverticulum, pharyngoesophageal pulsion diverticulum or pharyngeal pouch (thru cricopharyngeal muscle in midline of neck)
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What are the s/s of pharyngoesophageal pulsion diverticulum, midesophageal diverticula, and epiphrenic diverticula (large lower)?
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-difficulty swallowing, fullnes in the neck, belching, regurg, gurgling noises (pouch fills with food when pt reclines food in pouch is regurg-coughing, halitosis, sour taste)
-less acute -asymptomatic |
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What diagnostic test is done for diverticulum?
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barium swallow
-no esophagoscopy, no blind NG tube insertion |
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What is the treatement for diverticulum?
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surgical removal
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What can cause esophagus perforation?
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stab, bullet wound, trauma, chemical burn, puncture
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What are s/s and diagnostic test of perforation?
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pain, dysphagia, infection, fever, leukocytosis, hypotension
-x-ray, fluoroscopy |
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How is perforation of the esophagus treated?
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broad spectrum antibiotics, NPO, surgery, may heal on own
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How are swalloed foreign bodies treated?
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glucagon to relax esophageal muscle, endoscope to remove, sodium bicarb and tartaric acid to increase intraluminal pressure
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How are chemical burns caused and treated?
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-acid or base ingestion
-NPO, esophagoscopy, barium swallow, NG tube, antibiotics, corticosteriods, may need reconstruction |
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What is gastroesophageal reflux?
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excessive regurg into esophagus from incompetent lower esophageal sphincter, pyloric stenosis, or motility disorder
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What are the s/s of GERD?
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pyrosis (burning of esophagus), dyspepsia (indigestion), regurg, dysphagia, ordynophagia (pain on swallowing), hypersalivation, esophagitis
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What are diagnostic tests for GERD?
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endoscopy, barium swallow, esophageal pH monitoring, bilirubin monitoring
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How is GERD managed?
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low fat diet, avoid caffeine, tobacco, beer, milk, pepperment, spearmint, carbonated bev, 2 hours before bed, tight fitting clothes, normal body weight, elevate HOB, antacids, H2 receptors, proton pump inhibitors, surgery
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What is Barrett's esophagus?
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untreated GERD causing changes in cell lining the lower esophagus to precancerous cells
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What are the s/s and diagnostic tests for Barrett's esophagus?
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GERD, heartburn, peptic ulcer, esophageal stricture
-esophagogastroduodenoscopy, biopsy |
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What is the treatment for Barrett's esophagus?
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laser thermal ablation, transhiatal esophagectomy, esophageal surgery
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What is a common benign esophageal tumor, and how are they treated?
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leiomyoma, which can occlude lumen of esophagus
-excised during esophagoscopy |
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What are risk factors of esophageal cancer?
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chronic irritation (hot liquid or food), alcohol, tobacco, GERD, Barrett's esophagus, nutritional deficiencies, poor oral hygiene
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What are the two types of esophageal cancer cells?
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adenocarcinoma
squamous carcinoma *spread into lymphatics |
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What are the s/s of esophageal cancer?
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dysphagia, sensation of mass in the throat, pain or fullness, regurg, foul breath, hiccups, hemorrhaging, weight loss, substernal pain, resp difficulty
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How is esophageal cancer diagnosed?
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biopsy, CT, PET, endoscopic ultrasound
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How is esophageal cancer treated?
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surgery, radiation, chemo
*surgical resectioning has a high mortality rate from infection, pulm complications, leakage |
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What is the nursing interventions for esophageal surgery?
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weight gain, high protein/calorie, fowlers position, observed for dyspnea, aspiration, temp monitor, cardiac complications, NG monitor, upright after eating, vagotomy syndrome, oral suctioning
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What is vagotomy syndrome?
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dumping syndrome
-interruption of vagal nerve fibers causing pyloric emptying (diarrhea, severe cramping) -can be caused by Boost and Ensure |