NUR2392, MDCII – Examination Blue Print – Exam 3 Gastrointestinal System  Esophageal disorders (Assessment, S/S, Interventions)  Tumors-interventions: semisoft and thickened liquids, supplements, surgery  GERD  Contributing Factors Caffeine, chocolate, citrus fruits, tomatoes, peppermint, alcohol, smoking, pregnancy, obesity, bending forward, lying down after eating, NG tube placement, calcium channel blockers, nitrates, anticholinergic drugs  Risks  Assessment- dyspepsia, regurgitation, burping, farting, bloating, crackles, hoarseness, wheezing at night, chronic cough  Interventions- nutrition therapy, lifestyle changes, chronic disorder, ongoing management  Hiatal Hernia  Sliding vs Rolling- rolling clearly visible, sliding observed with position changes Sliding- development esophageal reflux, heartburn and chest pain, regurgitation, dysphagia and belching Rolling- No reflux, feelings after eating: breathlessness, chest pain, worse when recumbent, fullness  Assessment  Interventions-avoid late night eating, restricted diet, exercise, elevated head of bed, remain upright after eating, no tight clothes  Surgical care- soft diet, antireflux meds, report signs of infection o Oral Cavity Disorders (Assessment, S/S, Interventions)  Stomatitis-inflammation in oral cavity Assess for lesions/cracking lesions on pharynx may indicate extension down into esophagus, may need swallow studies Rinse with sodium bicarb solution every 2-3 hours, cool liquids, high protein & vitamin C  Oral Tumors (Leukoplakia vs Erythroplakia) Leukoplakia- (smoker’s patch) thickened white patches, slightly raised and rounded, can’t be removed by scraping  Erythroplakia- red lesions, precancerous  Oral Cancer- Mucosal  erythroplasia earliest sign  Red, raised, eroded areas  Lesion not healed within 2 weeks o Basal cell carcinoma  Asymptomatic  Resembles a scab  Primarily on lips  Karposi’s sarcoma  Malignant lesion in blood vessels  Raised, purple nodule/plaque  Usually painless