- dental plaque, a thin film on the teeth in saliva and often secondarily invaded by bacteria - strength of acids and the inability of the saliva to neutralize them - length of time the acids are in contact with the teeth - susceptibility of the teeth to decay

Cancer of the lip occurs most frequently as what? in men over the age of ______

A chronic ulcer of the lower lip 50

(disorder of the mouth: carcinoma of the oral cavity - medical management) large tumors usually require more extensive and traumatic surgery, in functional neck dissection of the neck cancer with no growth in the lymph nodes, the surgeon removes the lymph nodes but preserves the _______ ____, the _____________ ______ and the _____ ________ _____

Jugular vein sternocleidomastoid muscle spinal accessory nerve

(disorder of the mouth: carcinoma of the oral cavity - medical management) in radical neck dissection, all these structures are removed (lymph nodes, jugular vein, the sternocleidomastoid muscle, and spinal accessory nerve) AND what? is necessary after tissue resection

Reconstructive surgery

(disorder of the mouth: carcinoma of the oral cavity - medical management) patients may have drains in the incision sites that are connected to suction to ___ __________ and _______ _________

Aid healing reduce hematomas

(disorder of the esophagus: GERD - clinical manifestations) heartburn often is described as a substernal or retrosternal burning sensation that tends to _______ _________ and may involve the ______, ______, or the _______

Radiate upward neck, the jaw, or the back

(disorder of the esophagus: GERD - clinical manifestations) heartburn usually is experienced after eating, an atypical pain pattern that closely mimics _______ and heartburn must be differentiated carefully from what?

Angina true cardiac disease

(disorder of the esophagus: GERD - clinical manifestations) GERD primary and secondary symptoms

Primary: irritation of chronic reflux, produces heartburn secondary: regurgitation

(disorder of the esophagus: GERD - medical management) metoclopramide (raglan) is used in moderate to severe cases of GERD, it is in a class of drugs called what? these drugs increase peristalsis and therefore promote gastric emptying and reduce the risk of what?

Promobility agents gastric acid reflux

(disorder of the esophagus: carcinoma of the esophagus - pathophysiology) unfortunately, early esophageal cancer typically has ___ ________ that makes early diagnosis difficult

No symptoms

Nursing interventions for the patient experiencing esophageal surgery: postoperative nursing interventions: 1. promote good- 2. maintain chest- 3. maintain gastric- 4. maintain-

1. pulmonary circulation 2. drainage system 3. drainage system 4. nutrition

(disorder of the stomach: gastritis (acute) - assessment) collection of objective data includes observing for what? and melanoma caused by what?

Vomiting, hematemesis (vomiting blood), and melenoma caused by gastric bleeding

(disorder of the stomach: peptic ulcer disease - pathophysiology) the most common caused of peptic ulcer disease include the presence of what? where?

Helicobacter pylori (H. pylori) bacteria in the stomach

(disorder of the stomach: peptic ulcer disease - assessment) collection of objective data includes observing for signs of complications, _________ is a potential complication of PUD

Hemorrhage

(disorder of the stomach: peptic ulcer disease - assessment) when GI bleeding occurs, one sign is the vomiting of blood (hematemesis) that appears as what, resulting from what?

Either bright red, or a “coffee grounds”, the action of the gastric acid on hemoglobin

(disorder of the stomach: peptic ulcer disease - assessment) the patient may produce melena when GI bleeding occurs, melena is what?

Stool that is black and tarry with undigested blood

(disorder of the stomach: peptic ulcer disease - assessment) bleeding from a gastric ulcer can worsen quickly into an emergency situation if erosion is extensive, hemorrhage has an accompanying symptom of ______ and it occurs when?

Shock, when the ulcer erodes into a blood vessel

(disorder of the stomach: peptic ulcer disease - assessment) this is considered the most lethal complication of PUD

Perforation

(disorder of the stomach: peptic ulcer disease - medical management) histamine receptor blockers decrease acid secretions by blocking histamine receptors, some medications are ______, _______, ______, ______ and they should they not be given within when? (hint: “dine”)

Cimetidine, ranitidine, famotidine, nizatidine 2 hours of antacids

(medications for GI disorders) name a proton pump inhibitor and nursing intervention

Omeprazole - do not crush or chew

Purposes of nasogastric intubation - d_____________ - f_______ (______) - c___________ - l_______

- decompression - feeding (gavage) - compression - lovage

Dumping syndrome is a rapid gastric emptying of undigested food to the small intestine, causing what?

Distention of the duodenum or jejunum

Dumping syndrome is the direct result of surgical removal of a large portion of what?

The stomach and pyloric sphincter

Treatment of dumping syndrome includes eating six small meals daily that are high in _______ and ____ and low in __________, and they should eat slowly and avoid fluids during ______

High in protein and fat and low in carbohydrates meals

Treatment of dumping syndrome includes anticholinergic agents that do what? and reclining for approximately __ hour after meals

Decrease stomach mobility 1

(disorder of the intestine: infection - pathophysiology) antidiarrheals should not be given because these medications prevent the intestines from what?

Getting rid of the E. coli pathogen

(disorder of the intestine: infection - nursing interventions) assessment for fluid balance is important, including 1. skin turgor 2. mucous membrane hydration 3. urinary output 4. and measurement of postural changes in what?

Blood pressure

(disorder of the intestine: celiac disease (celiac sprue) - pathophysiology) celiac is a genetic disorder that most commonly affects the small intestine but can affect any part of the GI system, it is considered an autoimmune disease that disrupts the absorption of nutrients from foods in response to what?

The ingestion of gluten (a protein primarily found in wheat, rye, and barely)

(disorder of the intestine: celiac disease (celiac sprue) - pathophysiology) when these proteins are ingested (gluten), the immune system begins damaging the inner lining of the small intestine and destroying the _____

Villi

(disorder of the intestine: IBS - pathophysiology) anxiety disorders, depression, and forms of abuse, including physical, social, and sexual, are considered what?

Possible causes of IBS

(inflammatory bowel disease: ulcerative colitis - clinical manifestations) patients with severe ulcerative colitis may have as many as ___-___ liquid stools per day, and these liquid stools contain _____, _____, and ____

15-20 blood, mucus, and pus

(inflammatory bowel disease: ulcerative colitis - clinical manifestations) abdominal cramps may occur before the bowel movement, the urge to defecate lessens as what? progresses, and this results in what?

Scarring within the bowel, involuntary leakage of stool

(inflammatory bowel disease: chron’s disease - pathophysiology) chron’s disease can occur anywhere in the GI tract from the mouth to the anus but occurs most commonly where?

In the terminal ileum and proximal colon

(inflammatory bowel disease: chron’s disease - nursing interventions) tube feedings that allow rapid absorption in the upper GI tract are begun and then oral intake of a what? diet is introduced gradually

A low-residue, high-protein, high-calorie

(inflammatory bowel disease: chron’s disease - nursing interventions) when anemia is present, iron dextran is given by z-tract injection (because of irritation to the tissues) because oral intake of iron is what?

Ineffective because of intestinal ulceration

(acute abdominal inflammation: diverticulosis and diverticulitis - clinical manifestations) when diverticula perforate and diverticulitis develops, the patient complains of mild to severe pain in the left lower quad of the abdomen, and what else?

A fever, elevated WBC, and erythrocyte sedimentation rate, as well as the patient generally being hypotensive and tachycardic

(acute abdominal inflammation: diverticulosis and diverticulitis - clinical manifestations) if the condition goes untreated, ________ and _____ _____ can develop?

Septicemia and septic shock

(acute abdominal inflammation: diverticulosis and diverticulitis - clinical manifestations) intestinal obstruction can occur, causing _______ _______, _______, and _______

Abdominal distention, nausea, and vomiting

(acute abdominal inflammation: diverticulosis and diverticulitis - medical management) a diet high in fiber, mainly from where?, and a decreased intake of what? are recommended for preventing diverticular disease

Fresh fruits and vegetables fat and red meat

(acute abdominal inflammation: peritonitis - nursing interventions) nursing interventions for the patient with peritonitis include: - place the patient on bed rest in semi fowler’s position to help what? where? - give oral hygiene to prevent dying of what? and crackling of what? from what? - monitor fluid and electrolyte __________ - encourage deep breathing exercises; patient tends to have what? as a result of what? - use measures to reduce ______ - use meticulous surgical asepsis for wound care, instruct patient about the importance of what?

- localize purulent exudate in the lower abdomen or pelvis - mucous membranes and crackling of lips from dehydration - fluid & electrolyte replacement - shallow respirations as a result of abdominal pain or distention - reduce anxiety - ambulation, coughing, deep-breathing, incentive spirometer & leg exercises

(hernias: external hernias - pathophysiology) the hernia is strangulated when it occludes what?, to prevent anaerobic infection in the area, what? is performed when a hernia strangulated

Occludes blood supply and intestinal flow immediate surgical intervention

(hernias: external hernias - pathophysiology) if complications such as what? follow, the patient may have what?

Incarceration or strangulation bowel obstruction, vomiting, abdominal distention

(hernias: external hernias - nursing interventions) the patient should deep breathe every ___ hours, but many surgeons discourage ________. teach the patient how to support the incision by what?

2 hours coughing splinting the area with a pillow or pad

Jaundice, the discoloration of body tissues caused by what?, is visible when the total serum bilirubin exceeds ___ mg/dL

Abnormally high blood levels of bilirubin 2.5mg/dL

(disorder: liver cancer - pathophysiology) the type of primary liver cancer seen most frequently is hepatocellular carcinoma; the other primary tumors are what?

Cholangionomas or biliary duct caricinomas

(disorder: liver cancer - pathophysiology) cirrhosis of the liver and infection with what? are high risk factors for primary liver cancer

Hepatitis B or hepatitis C

(modes of transmission of the 6 types of viral hepatitis) - hep A: spreads through direct contact through the ____-_____ route usually by ____ or _____ contaminated by ____ - hep B: transmitted by contaminated ____ via ____ _______, contaminated _____, ________, __ ___ ___, and direct contact with ___ ____ from _____ _____ - hep C: transmitted though ________, ____ _________, ____ ______ ____ - hep E: transmitted though the ____-_____ route, spreads through _____ contamination of _____

- hep A: oral-fecal route usually by food or water contaminated by feces - hep B: contaminated serum via blood transfusion, contaminated needles, needlesticks, IV drug use, and direct contact with body fluids from infected people - hep C: needlesticks, blood transfusions, IV drug use, and unidentified means - hep E: oral-fecal route, fecal contamination of water

(disorder: cholecystitis and cholelithiasis - clinical manifestations) acute, with a sudden onset of indigestion, nausea and vomiting and severe, ______ pain in what? quadrant of the abdomen the pain may be referred to where?

Colicky pain in the right upper quad the right shoulder and scapula

(disorder: cholecystitis and cholelithiasis - clinical manifestations) pain resulting from this disorder is sometimes mistaken for what? because of the pain that is felt where?

A cardiac problem in the epigastric region and radiating to the back

(disorder: cholecystitis and cholelithiasis - clinical manifestations) when gallstones move through the biliary ducts, the patient often complains of pain being ________

Intensified

(disorder: cholecystitis and cholelithiasis - medical management - surgical intervention) treatment of choice is what? (removal of the gallbladder) with legation of what?

Cholecystectomy the cystic duct, vein, and artery

(disorder: cholecystitis and cholelithiasis - medical management - surgical intervention) a laparoscopic _________ and open _____ __________ are the two surgical procedures

Cholecystectomy abdominal cholecystectomy

(lifespan considerations: older adults) as the body ages, the number and size of hepatic cells _________, which results in an overall reduced what?

Decreases size and weight of the liver

(lifespan considerations: older adults) be alert to the signs and symptoms of ____ ________, even when the drugs are administered in normal doses, because the decreased metabolism in the liver can cause what?

Drug toxicity accumulation

(disorder: pancreatitis - pathophysiology) _________ and ______ ____ ______ are the two factors most commonly associated with pancreatitis

Alcoholism and biliary tract disease

(disorder: cancer of the pancreas -pathophysiology) although once considered relatively rare, pancreatic cancer is now the __th leading cause of cancer death in the US and Canada

(disorder: cancer of the pancreas -pathophysiology) a major factor in the high death rate from pancreatic cancer is the difficulty in diagnosing it at what?

An early, curable stage

(disorder: cirrhosis - pathophysiology) increased pressure causes _______ (an accumulation of fluid and albumin in the peritoneal cavity)

Ascites

(disorder: cancer of the pancreas -pathophysiology) the normal liver inactivates the hormone __________, but the damaged liver allows its effect to continue

Aldosterone

(disorder: cancer of the pancreas -pathophysiology) retention of _____ and ______ results in _______ pressure in _______ _______and lymphatic channels, resulting in ______ ________ ascites is thus a result of ______ ________, hypoalbuminemia, and hyperaldosteronism

Fluid and sodium results in increased pressure in blood vessels and lymphatic channels, resulting in portal hypertension a result of portal hypertension, hypoalbuminemia, and hyperaldosteronism

(disorder: cancer of the pancreas -pathophysiology) ________ results from an accumulation of ___ ____ under the skin, the result of ________

Pruritus results from bile salts under the skin, the result of jaundice