NU144- Chapter 45: Management of Patients With Oral and Esophageal Disorders
When assessing a client during a routine checkup, the nurse reviews the history and notes that the client had aphthous stomatitis at the time of the last visit. How is aphthous stomatitis best described by the nurse?
A canker sore of the oral soft tissues
A nurse caring for a client who has had radical neck surgery notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What is an expected, normal amount of drainage?
Approximately 80 to 120 mL
The nurse teaches the client with gastroesophageal reflux disease (GERD) which measure to manage the disease?
Avoid eating or drinking 2 hours before bedtime.
The nurse is creating a plan of care for a client who is not able to tolerate brushing his teeth. The nurse includes which mouth irrigation in the plan of care?
Baking soda and water
The nurse is caring for a client with a history of bulimia. The client complains of retrosternal pain and dysphagia after forcibly causing herself to vomit after a large meal. The nurse suspects which condition?
Boerhaave syndrome
Which is an accurate statement regarding cancer of the esophagus?
Chronic irritation of the esophagus is a known risk factor.
An elderly client seeks medical attention for a vague complaint of difficulty swallowing. Which of the following assessment findings is most significant as related to this symptom?
Esophageal tumor
An elderly client states, "I don't understand why I have so many caries in my teeth." What assessment made by the nurse places the client at risk for dental caries?
Exhibiting hemoglobin A1C 8.2
Postoperatively, a client with a radical neck dissection should be placed in which position?
Fowler
A client with human immunodeficiency virus (HIV) comes to the clinic and is experiencing white patches on the lateral border of the tongue. What type of lesions does the nurse document?
Hairy leukoplakia
The nurse is caring for a client during the postoperative period following radical neck dissection. Which finding should be reported to the physician?
High epigastric pain and/or discomfort
A client is being evaluated for esophageal cancer. What initial manifestation of esophageal cancer should the nurse assess?
Increasing difficulty in swallowing
The nurse is creating a discharge teaching plan for a client after surgery for oral cancer. Which should be included in the teaching plan? Select all that apply.
Oral hygiene Follow-up dental appointment Follow-up medical appointment Use of humidification
A patient has been diagnosed with a hiatal hernia. The nurse explains the diagnosis to the patient and his family by telling them that a hernia is a (an):
Protrusion of the upper stomach into the lower portion of the thorax.
Which term is used to describe stone formation in a salivary gland, usually the submandibular gland?
Sialolithiasis
An older adult patient who has been living at home alone is diagnosed with parotitis. What causative bacteria does the nurse suspect is the cause of the parotitis?
Staphylococcus aureus
A client with an esophageal stricture is about to undergo esophageal dilatation. As the bougies are passed down the esophagus, the nurse should instruct the client to do which action to minimize the vomiting urge?
Take long, slow breaths
A client has a new order for metoclopramide. What extrapyramidal side effect should the nurse assess for in the client?
Uncontrolled rhythmic movements of the face or limbs
Cardiac complications, which may occur following resection of an esophageal tumor, are associated with irritation of which nerve at the time of surgery?
Vagus
Which of the following assessment findings would be most important for indicating dumping syndrome in a postgastrectomy client?
Weakness, diaphoresis, diarrhea 90 minutes after eating
pyrosis
a burning sensation in the stomach and esophagus that moves up to the mouth commonly called heartburn
temporomandibular disorders
a group of conditions that cause pain or dysfunction of the temporomandibular joint and surrounding structures
Frey syndrome
a rare syndrome characterized by undesirable sweating and flushing occurring on the cheek, temporal region, and behind the ears after eating certain foods also called auriculotemporal syndrome
dysplasia
abnormal change in cells
periapical abscess
abscessed tooth
achalasia
absent or ineffective peristalsis (wavelike contraction) of the distal esophagus accompanied by failure of the esophageal sphincter to relax in response to swallowing
dysphagia
difficulty swallowing
gastroesophageal reflux disease (GERD)
disorder marked by backflow of gastric or duodenal contents into the esophagus that causes troublesome symptoms and/or mucosal injury to the esophagus
xerostomia
dry mouth
vagotomy syndrome
dumping syndrome gastrointestinal symptoms, such as diarrhea and abdominal cramping, resulting from rapid gastric emptying
halitosis
foul odor from the oral cavity in laymen's terms, "bad breath"
gingivitis
inflammation of the gums change in color from pink to red, with associated swelling, bleeding, and sensitivity/tenderness
stomatitis
inflammation of the oral mucosa
parotitis
inflammation of the parotid gland
sialadenitis
inflammation of the salivary glands
The nurse is providing discharge instructions for a slightly overweight client seen in the Emergency Department with gastroesophageal reflux disease (GERD). The nurse notes in the client's record that the client is taking carbidopa/levodopa. Which order for the client by the health care provider should the nurse question?
metoclopramide
odynophagia
pain on swallowing
hernia
protrusion of an organ or part of an organ through the wall of the cavity that normally contains it
Boerhaave syndrome
spontaneous esophageal rupture due to forceful vomiting or straining
lithotripsy
the use of shock waves to break up or disintegrate stones
A client who had oral cancer has had extensive surgery to excise the malignancy. Although surgery was deemed successful, it was quite disfiguring and incapacitating. What is essential to this client and family?
time to mourn, accept, and adjust to the loss
The nurse instructs the client with gastroesophageal reflux disease (GERD) regarding dietary measures. Which action by the client demonstrates that the client has understood the recommended dietary changes?
Avoiding chocolate and coffee.
Which clinical manifestation is not associated with hemorrhage?
Bradycardia
A client is diagnosed with a hiatal hernia. Which statement indicates effective client teaching about hiatal hernia and its treatment?
"I'll eat frequent, small, bland meals that are high in fiber."
A client is postoperative following a graft reconstruction of the neck. What intervention is the most important for the nurse to complete with the client?
Assess the graft for color and temperature.
A client has been taking a 10-day course of antibiotics for pneumonia. The client has been having white patches that look like milk curds in the mouth. What treatment will the nurse educate the client about?
Nystatin
A client with cancer has a neck dissection and laryngectomy. An intervention that the nurse will do is:
Make a notation on the call light system that the client cannot speak.
The term for a reddened circumscribed lesion that ulcerates and becomes crusted and is a primary lesion of syphilis is a(n)
chancre.
The most common symptom of esophageal disease is
dysphagia.
While caring for a patient who has had radical neck surgery, the nurse notices an abnormal amount of serosanguineous secretions in the wound suction unit during the first postoperative day. What does the nurse know is an expected amount of drainage in the wound unit?
Approximately 80 to 120 mL
When caring for a client with the impaired swallowing related to neuromuscular impairment, what is the nurse's priority intervention?
Elevate the head of the bed 90 degrees during meals.
The client has returned to the floor following a radical neck dissection. Anesthesia has worn off. What is the nurse's priority action?
Place the client in the Fowler's position.
The nurse provides health teaching to inform the client with oral cancer that
many oral cancers produce no symptoms in the early stages.
