GIT Disorders

Friday, February 4, 2022 11:39 AM

Git Disorders Define Risk Factors Surgical Management Clinical Findings Assessment Med Management
(post OP)
Conditions
affecting ORAL
CAVITY
Cleft Lip Congenital anomaly involving cleft in Family history Repair 3 mos. (rule of 10): Cleft upper lip - feed
(cheiloschisis) upper lip, may occur independently Cheiloplasty upright, large nipple
but frequently occurs together Exposure to certain holes, special lamb
substances during Maintain airway, avoid nipple
Can be unilateral (incomplete) or pregnancy prone
Bilateral (complete) Mouth breathing -
Elbow restraints, check q encourage early use of
2hr spoon and cup

Prevent crust formation Difficult sucking

on suture line (NSS,
Hydrogen peroxide)
Prevent pressure on
suture line: avoid crying,
Logan's Bow, Analgesic
Cleft Palate Congenital anomaly involving cleft in Having diabetes Repair 2 yrs.
(palatoschisis) palate (palatoplasty)
Being obese during
Repair: Cheiloplasty pregnancy Protect site: no straws,
Rule of 10: 10wks, 10 lbs, Hgb of 10 toothbrush, hard
Side lying
Liquid diet, no milk-> soft
(breastfeeding may be
more effective) - burp
frequently, allow to
swallow
Aspiration pneumonia
Altered speech
Recurrent otitis media
Dental development -
promotes parent infant
bonding

Analgesic
Oral cancer Uncommon, highest amongst males Excessive sun Ulcers irregular borders Position:
over 40 yrs. Old exposure Mouth irrigation:
Leukoplakia
Appears as growth/sore in the mouth Tobacco, Alcohol Nutritional support: Tube
does not go away Difficulty chewing, feedings
Human dysphagia Monitor for facial nerve
Cancers of the lips, tongue, cheeks, Papillomavirus damage
floor of the mouth, hard and soft (HPV) Unexplained bleeding in
palate, sinuses, and pharynx (throat) the mouth Post radiation/chemotherapy
care
Unexplained numbness,
loss of feeling, or
pain/tenderness in any
area of face, mouth,
neck

Hoarseness, chronic
sore throat or change in
voice

Ear pain

Change in way your

teeth/dentures fit
together

Dramatic weight loss

Dx: positive cytology

test

Esophageal Define Therapeutic Medications Nursing Intervention Assessment Diagnostic procedures

Disorders Procedures

GERD, Reflux of the gastric Surgery (Nissen ANTACIDS: Educate: Pyrosis (heartburn) Barium swallow, UGI
Chalasia contents into esophagus Fundoplication) - -Aluminum H. (Mylanta, Diet - High protein, low Regurgitation Endoscopy
(Gastro - - Incompetent LES Laparoscopy Amphogel): Const. fat Nausea Esophageal manometry
stomach, -Magnesium: MOM: diarrhea - Small frequent A recurring sour/bitter - Monitor pressure of
Esophageal - Barrett's esophagus -Aluminum/Magnesium: Maalox, feedings (infants: taste in the mouth muscle contractions in
esophagus, Gaviscon thicken w/ rice the lower part of the
Reflux - to -Sodium Preps: Tums meal), upright Causes: esophagus while

Wednesday - GIT Page 1

Reflux - to -Sodium Preps: Tums meal), upright Causes: esophagus while
flow back) - 1 to 3 hrs. PC and bedtime after meal, avoid - Weakness swallowing
(acid highest) eating before - Increase ABD - NPO before test
- At least 1 hour from other going to bed pressure: obesity,
meds - No alcohol, tight clothing,
- Chew tab carbonated, pregnancy
-H2 Block: caffeinated, acidic Relaxation of LES:
Ranitidine (Zantac), Famotidine fruits - Smoking,
(Pepcid), Nizatidine (Acid) and Lifestyle: avoid tight- caffeine, alcohol
cimetidine (Tagamet) fitting clothing, lose - Drugs (nitrates,
-Proton Pump Inhibitor: weight, no smoking, calcium channel
Pantoprazole (Protonix), elevated HOB (6 to 8 in): blockers, Valium)
Omeprazole (Prilosec), blocks - Foods (fatty,
Lansoprazole (Prevacid) citrus, tomatoes,
spicy)
Hiatal Hernia Protruding of stomach out Antacids, H2 blockers, Analgesics Medications Substernal pain Upper GI series
of the diaphragm Dysphagia
- Small frequent, head Avoid HIATAL
Types: elevation Hot and spicy
Sliding: portion of stomach Ingestion of large meals
slips into thoracic cavity Apparel that constrictive
Twisting/bending/lifting
Paraoesophageal: fundus Alcohol
rolls out of stomach and Limit carbonated
forms a pocket beverages

Surgery
Esophageal Begins in the cells that line Radiation Post operations: Dysphagia Barium swallow
Cancer the inside of the esophagus Choking, Hoarseness,
Surgery: Semi-Fowler's cough Esophagoscopy w/ biopsy
Esophageal cancer can Esophagectomy: graft NGT/Gastrostomy care
occur anywhere along the High-calorie, high-
esophagus Esophagogastrostomy protein diet
Post radiation care
More men than women get
esophageal cancer

More common in men

between 50-70 years old

Risk factors:
- Smoking, alcohol,
poor oral hygiene,
achalasia
- Barrett's esophagus
Esophageal Dilated veins exist in the Saline lavage, Drugs: propranolol Avoid alcohol EGD
Varices distal esophagus esophagogastric Vasopressin Eat a healthy diet Endoscopic banding
balloon tamponade, Vit K Maintain a healthy Emergency (TIPS) -
Can rupture and cause BT, ligations and Octreotide IV weight Transjugular intrahepatic
massive bleeding sclerotherapy Monitor VS and Hgb Use chemical sparingly portosystemic shunting
Mouth care and carefully CBC, PT, liver function test
Causes:
Severe liver scarring
(cirrhosis)
Blood clot (thrombosis)
Alcoholism

Wednesday - GIT Page 2