NursingCareofClientswithUpperGastrointestinalDisorder1

NursingCareofClientswithUpperGastrointestinalDisorder1 -...

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Nursing Care of Clients with Upper Gastrointestinal Disorders I. Care of Clients with Disorder of the Mouth A. Disorder includes inflammation, infection, neoplastic lesions B. Pathophysiology 1. Causes include mechanical trauma, irritants such as tobacco, chemotherapeutic agents 2. Oral mucosa is relatively thin, has rich blood supply, exposed to environment C. Manifestations 1. Visible lesions or erosions on lips or oral mucosa 2. Pain
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Nursing Care of Clients with Upper Gastrointestinal Disorders D. Collaborative Care 1.Direct observation to investigate any problems; determine underlying cause and any coexisting diseases 2.Any undiagnosed oral lesion present for > 1 week and not responding to treatment should be evaluated for malignancy 3.General treatment includes mouthwashes or treatments to cleanse and relieve irritation a.Alcohol bases mouthwashes cause pain and burning b.Sodium bicarbonate mouthwashes are effective without pain 4. Specific treatments according to type of infection a.Fungal (candidiasis): nystatin “swish and swallow” or clotrimazole lozenges b.Herpetic lesions: topical or oral acyclovir
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Nursing Care of Clients with Upper Gastrointestinal Disorders E. Nursing Care 1. Goal: to relieve pain and symptoms, so client can continue food and fluid intake in health care facility and at home 2. Impaired oral mucous membrane a. Assess clients at high risk b. Assist with oral hygiene post eating, bedtime c. Teach to limit irritants: tobacco, alcohol, spicy foods 3. Imbalanced nutrition: less than body requirements a. Assess nutritional intake; use of straws b. High calorie and protein diet according to client preferences
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Client with Oral Cancer 1.Background a. Uncommon (5% of all cancers) but has high rate of morbidity, mortality b. Highest among males over age 40 c. Risk factors include smoking and using oral tobacco, drinking alcohol, marijuana use, occupational exposure to chemicals, viruses (human papilloma virus)
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Client with Oral Cancer 2.Pathophysiology a. Squamous cell carcinomas b. Begin as painless oral ulceration or lesion with irregular, ill-defined borders c. Lesions start in mucosa and may advance to involve tongue, oropharynx, mandible, maxilla d. Non-healing lesions should be evaluated for malignancy after one week of treatment
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Client with Oral Cancer 3. Collaborative Care a. Elimination of causative agents b. Determination of malignancy with biopsy c. Determine staging with CT scans and MRI d. Based on age, tumor stage, general health and client’s preference, treatment may include surgery, chemotherapy, and/or radiation therapy e. Advanced carcinomas may necessitate radical neck dissection with temporary or permanent tracheostomy; Surgeries may be disfiguring f. Plan early for home care post hospitalization, teaching family and client care involved post surgery, refer to American Cancer Society, support groups
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Client with Oral Cancer 4. Nursing Care a. Health promotion: 1.
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  • Spring '14
  • Ferguson
  • Nursing, Nursing Care, Bowel obstruction, bowel

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