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
, ▪ On hard palate
• Salivary Gland Disorders
Sialadenitis- inflammation of gland, bacterial or viral, decrease saliva production
Interventions: hydration, warm compress, massage gland, saliva substitute
Tumors- facial weakness or paralysis, assess facial nerve (CN VII) by wrinkling nose and brows,
pucker lips, puff out cheeks, smile
o Stomach Disorders
• Gastritis (Risks, Assessment, S/S, Intervention)
▪ Treatment: Medications & Education
• Peptic Ulcer Disease (Etiology & Complications)
▪ Medication Management
▪ Interventions
• Upper GI Bleed (Risks, Assessment, S/S, Intervention)
• Gastric Cancer (Assessment, S/S, Intervention)
• Dumping Syndrome (Assessment, S/S, Intervention, Education)
Non-Inflammatory Disorders
o Etiology, Assessment S/S, Interventions, & Management
• Obstruction & Fecal Impaction
▪ S/S- Nausea & Vomiting, Cramping, Abdomen distention, Pain, Obstipation,
Long history of constipation, Fever, Tachycardia
▪ Complications: High obstruction- Metabolic alkalosis, Low
obstruction- Metabolic acidosis, Peritonitis, Strangulated obstruction
• Interventions: Monitor Vital Signs
▪ Assess abdomen (BS, distention, flatus)
▪ Monitor fluid and electrolyte status
▪ Pain management
▪ Manage nasogastric tube
▪ Drainage
▪ Patency
▪ Placement
▪ Irrigate
▪ Mouth and nares care
▪ Semi-Fowlers position
• Preventing:
▪ Eat high-fiber foods; raw fruits & veggies, whole-grain
▪ Drink adequate amounts of fluids, esp water
▪ No routine laxatives
▪ Encourage regular exercise – walking daily
▪ Natural foods to stimulate peristalsis – warm beverages, prune juice
▪ Bulk-forming foods: Metamucil
▪ Check stool for amount & frequency
▪ Sit on toilet or commode rather than bed pan for elimination
• Polyps- Small mucosal growths attached to surface of intestines
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
, ▪ On hard palate
• Salivary Gland Disorders
Sialadenitis- inflammation of gland, bacterial or viral, decrease saliva production
Interventions: hydration, warm compress, massage gland, saliva substitute
Tumors- facial weakness or paralysis, assess facial nerve (CN VII) by wrinkling nose and brows,
pucker lips, puff out cheeks, smile
o Stomach Disorders
• Gastritis (Risks, Assessment, S/S, Intervention)
▪ Treatment: Medications & Education
• Peptic Ulcer Disease (Etiology & Complications)
▪ Medication Management
▪ Interventions
• Upper GI Bleed (Risks, Assessment, S/S, Intervention)
• Gastric Cancer (Assessment, S/S, Intervention)
• Dumping Syndrome (Assessment, S/S, Intervention, Education)
Non-Inflammatory Disorders
o Etiology, Assessment S/S, Interventions, & Management
• Obstruction & Fecal Impaction
▪ S/S- Nausea & Vomiting, Cramping, Abdomen distention, Pain, Obstipation,
Long history of constipation, Fever, Tachycardia
▪ Complications: High obstruction- Metabolic alkalosis, Low
obstruction- Metabolic acidosis, Peritonitis, Strangulated obstruction
• Interventions: Monitor Vital Signs
▪ Assess abdomen (BS, distention, flatus)
▪ Monitor fluid and electrolyte status
▪ Pain management
▪ Manage nasogastric tube
▪ Drainage
▪ Patency
▪ Placement
▪ Irrigate
▪ Mouth and nares care
▪ Semi-Fowlers position
• Preventing:
▪ Eat high-fiber foods; raw fruits & veggies, whole-grain
▪ Drink adequate amounts of fluids, esp water
▪ No routine laxatives
▪ Encourage regular exercise – walking daily
▪ Natural foods to stimulate peristalsis – warm beverages, prune juice
▪ Bulk-forming foods: Metamucil
▪ Check stool for amount & frequency
▪ Sit on toilet or commode rather than bed pan for elimination
• Polyps- Small mucosal growths attached to surface of intestines
