MDC2 Final Exam Study Guide
*The exam questions are not limited to only what is listed on this guide. Please refer to your chapter readings,
recordings, and module materials. ATI has additional practice questions for review in Learning Systems RN 3.0.
Ch. 53 – Care of Patients with Oral Cavity Problems
Stomatitis and care
o What is stomatitis?
Inflammation within the oral cavity.
o Assessment of Stomatitis:
Blisters in the oral cavity with pain and swelling
Fever
Difficulty Eating and drinking.
o Nursing Interventions:
Provide frequent oral care (q 2hrs)
Mouth rinsing with saline, baking soda
Monitor VS (temp)
Monitor I&O
Be alert for sx of dysphagia (risk for aspiration)
Offer bland, nonacidic foods – cool liquids
Apply topical analgesics
o Meds:
Tetracycline Syrup
Minocycline, chlorhexidine mouthwash
Acyclovir
Nystatin oral suspension
Leukoplakia vs. Erythroplakia
o Leukoplakia: thickened, white patches that cannot be easily flaked off
Usually benign
o Erythroplakie: red, velvety mucosal leasion
Considered precancerous
Most commonly on floor of mouth
Ch. 54 – Care of Patients with Esophageal Problems
GERD risk factors and treatment
o Risk factors:
Obesity/overweight
Hiatal hernias
o Treatment:
Nutrition Therapy, lifestyle changes and drug therapy.
Nutrition: eliminate foods that decrease LES pressure (peppermint, chocolate,
alcohol, fatty foods, caffeine, carbonated beverages, spicy/acidic food)
Lifestyle changes: smoking cessation, decrease size of meals, avoid eating atleast
3 hours before bed. Sleed 6-12 elevated.
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, Drug therapy: Antacids, histamine receptor antagonists, PPI’s
Surgical Management: Nissen fundoplication
Hiatal hernia symptoms
o Symptoms:
Heartburn, regurgitation, CP, dysphagia, belching
Endoluminal fundoplication (hiatal hernia repair) vs. Nissen fundoplication (GERD surgical
management)
Ch. 55 – Care of Patients with Stomach Disorders
Types of ulcers (gastric vs. duodenal)
o Gastric Ulcers:
Develop in the atrum of the stomach near acid-secreting mucosa
o Duodenal ulcers
Upper portion of the duodenum that penetrate through the mocsa and
submucosa.
High gastric acid secretion
Complications of ulcers
o Hemorrhage – usually in gastric ulcers
massive bleeding = hematemesis
Minimal bleeding: tarry stool
o Perforation
Ulcer becomes deep and thickness of stomach is worn away
Sx include sudden sharp pain in the epigastric region.
Stomach contents leak into peritoneal cavity
Health promotion and avoidance of triggers (balanced diet, limit spicy foods, tobacco, alcohol,
NSAIDS, etc.)
Treatment (pain relief, triple therapy)
Ch. 56 – Care of Patients with Noninflammatory Intestinal Disorders
Nonmechanical (ileus) vs. mechanical obstruction (intussusception, volvulus, etc.)
o Mechanical:
Bowel is physically blocked by problems such as tumors and adhesions
Intussusception is telescoping of intestines
Volvulus is twisting of intestin
o Nonmechanical:
Due to peristalsis and back up of stool.
Colorectal cancer labs (CEA), diagnostics
o CEA: carcinoembryonic antigen
Normal value 5ng/mL – usually elevated in pts with CRC
Used to monitor effectiveness of tx and ID dz recurrence.
o FOBT: fecal-occult blood test
Indicates bleeding in GI tract.
o Sigmoidoscopy, Colonoscopy.
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