NUR 105 GI
- Oral Cavity Problems
Answer AIRWAY is most important!!!!!! where digestion begins
- Oral Cavity problems concerns
- Stomatitis
- or multiple ulcers
- Stomatitis
Answer Aspiration/Airway Dentition/Nutrition Speech/Communication Body Image
Answer inflammation/irritation of the oral mucosa ulcer in the mouth
Answer Primary stomatitis- can not prevent Secondary- from a virus, fungi, bacteria, medications
- Primary stomatitis
Answer Trauma
- Secondary stomatitis
Answer Example- candidiasis from a fungal infection
- At risk patients for secondary stomatitis 1 / 4
Answer ABX, chemo, long-term steroids, any immunocompromised pt
- Etiology of stomatitis
Answer Infection- viral, bacterial, fungal Foods- citrus fruits, tomatoes, hot, spicy
Vitamin deficiency- iron, folate, Vitamin B Systemic Diseases- HIV, cancer, colitis, recurrent bacterial infections
- Nursing assessment for stomatitis
Answer Always start with history!
Ask about- Diet (gives an idea of lab), recent infection, medications, medical history, OLD CARTS all the symptoms
- Physical assessment (stomatitis)
Answer assess swallowing and ability to communicate
establish means of communication assess submandibular lymph nodes (rule out infection)
- Lab assessment for stomatitis
Answer Nutrition status CBC
Cultures and staining- only for recurrent infection, to find treatment
- Manifestations stomatitis
Answer Dry painful mouth and open ulcers Candidiasis- thick white coating on the tongue that can be scraped away, when scraped away- red sore tissue will be underneath 2 / 4
- Planning and Implementation stomatitis
Answer Educate to use soft bristle toothbrush
rinse oral cavity with saline (no commercial mouthwash) mouth care every 2 hr and twice at night avoid chips, spicy food, hot liquids
- Drug therapy for stomatitis
Answer ABX- tetracycline and monocycline (swish and swallow)
Antifungals- nystatin (swish and swallow) IV- acyclovir for pts with HIV (viral)
- Magic mouthwash
Answer Combination of Mycostatin, benadryl, and lidocaine. Used to swish and spit. Helps with pain related to stomatitis.
Assess swallowing
- Premalignant lesion
Answer Leukoplakia
Most common oral lesion among adults Most benign
Thickened, white, firmly attached patches that are slightly raised and sharply circumscribed (can see borders)
- Leaukoplakia
Answer Results from long term mechanical irritation Smoking 3 / 4
Biting inside of cheek Broken teeth Poor fitting dentures "Smokers patch"
- Erythroplakia
Answer Red, velvety mucosal lesions on the surface of the oral mucosa Higher degree to become malignant
Most commonly found on soft palate This is the one you do not want
- Erythroplakia issue
Answer body image!!!!!
- Squamous cell carcinoma
Answer Worst and most common malignant lesion RED, RAISED, ERODED!!!Highly associated with aging and tobacco use
21. TNM
Answer Tumor- size Nodes- Location Metastitis- has it grown
- Risk factors of Sqaumous Cell Carcinoma
Answer Aging Tobacco use
Alcohol Sunlight Poor nutrition
- Basil Cell Carcinoma
- / 4
Answer Occurs primarily on the lips