What is it?
What is Candidiasis?
Thrush or yeast on tongue. Looks like milk curd on the tongue.
How do you treat thrush?
Nystatin or Magic mouthwash (tetracaine, hydrocortisone, nystatin, xylocaine, benadryl, Maalox/mylanta.
What are some risk factors for thrush?
debilitation; increased does of antibiotics, steroids.
What are s/s of thrush?
pearly white "milk curd"; sore mouth; yeast breath
What pt teaching do we teach for their meds for thrush?
For Mycostatin (nystatin), have pt swish mouth with the med for a min before swallowing liquid.
What is Oral cancer?
Mostly arises from squamous cells of the oral cavity.
What are treatments for oral cancer?
Combination of surgery, chemo and radiation. Can also be given Cetuximab (Erbitux) which stops the growth of new blood vessels that cancers need to grow.
What are risk factors for oral cancer?
What are s/s of oral cancer?
What are nursing interventions for oral cancer? Pre, post and overall.
Pre-op: teach about surgery, encourage expression of fear, explain post op care, set up means of communication.
Post-op: promote drainage of secretions- side laying or semi-fowlers, suction mouth, watch suture lines.
Assess airway, assess for facial nerve damage, oral hygiene, pain meds, nutrition via NG and PEG, communication techniques, speech consult.
What is GERD?
Backflow of gastric or duodenal contents, or both, into the esophagus and past the lower esophageal sphincter.
What are ways to treat GERD?
Antiacids (mylanta), H2 blockers (pepcid, tagamet, Axid), PPI's (Prilosec, Prevacid, Protonix, Aciphex, Nexium), Motility Drugs (Urecholine and Reglan). We can also do surgery like a fundoplication and stretta procedure.
Actions that relax the LES (smoking, ETOH, meds- morphine, valium, demerol, atropine), any conditions that increase intra-adbominal pressure (obesity, pregnancy, ascites), long term NG tube, and pyloric surgery which allow reflux of bile or pancreatic juice
What are s/s of GERD?
heartburn, regurgitation, dysphagia, belching or flatulence, nocturnal cough, hoarseness or wheezing, sternal chest pain, and tooth erosion.
what are nursing interventions/teaching for GERD?
Dietary teaching (Low fat- high fiber, no caffeine, ETOH, carbonated drinks, chocolate, no large meals, no spicy food or foods that increase heartburn, avoid large meals), no heavy lifting, weight reduction, smoking cessation, sleep with HOB up, monitor for aspiration at night.
What is hiatal hernia?
Portion of the stomach and esophagus are moved through a portion of hiatus into the thorax. Pushed up past the diaphragm.
What are the treatments for a hiatal hernia?
You can give meds (antacids, H2 blocker, PPI's), diet changes (same as GERD), weight reduction, and surgery (fundoplication). What is fundoplication?
What is the risk factors for hiatal hernia?
We don't know the actual cause, could be age, trauma, surgery, congenital.
What are s/s of hiatal hernia?
Cough, dysphagia (difficulty swallowing), dyspnea (shortness of breath), feeling of fullness, regurgitation/vomiting, and sternal pain after eating.
How can you dx hiatal hernia?
Most are diagnosed in workup for GERD, barium swallow, and chest x-ray.
What is Zenker's diverticulum?
Also called esophageal diverticula, it's a bulging in the esophageal mucosa through a weakened portion of the muscular layer, a pocket where undigested food can go.
what are ways to treat Esophageal diverticula?
Surgery (herniated sac is excised and esophageal opening is closed, will have chest tubes), antibiotics post-op, and maintain airway.
What are risk factors for Zenker's diverticulum?
Adults over 50, history of esophageal motility problem, history of esophagitis
What are s/s of esophageal diverticula?
Pain with swallowing, gurgling noises in esophagus (Boyce's sign), cough, breathing with foul odor r/t decomposing food, food regurgitation with eating, bending or laying down.
How do you dx esophageal diverticula?
Barium swallow or endoscopy.