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NURS 612 AHA EXAM 1 (CHEN-WALTA REVIEW) (1)  

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NURS 612 AHA EXAM 1 (CHEN-WALTA REVIEW) (1)   AHA Exam 1 (Chen-Walta review) Normal and Abnormal findings in elderly mouth/pharynx General: ● Chronic disease increases the burden of oral disease, predisposing older adults to oral microbial infections, pain, altered taste, difficulty chewing and speaking, and dysphagia. ● Poor oral health can lead to weight loss ○ Periodontal disease is the 6th leading complication of diabetes and can inhibit glycemic control and poor glycemic control can contribute to periodontal disease ○ Xerostomia (dry mouth) impairs oral function, promotes tooth decay, exacerbates periodontal disease which can be caused by many medications. ○ Oral cancer is the 8th most common cancer in men and 7x more likely in older adults ○ Aspiration pna is a major cause of hospitalization and results in 20-50% mortality, oral hygiene can decrease this incidence. ○ 23% have untreated cavities and 70& periodontal disease ○ 1/3 are fully edentulous (missing all natural teeth) or average 19 or less remaining teeth ○ 17% have orofacial pain, facial, oral sores, burning mouth, and toothache Abnormal: ■ Gingivitis: which is associated with plaque, hormonal changes, or foreign- body response ■ Periodontal disease is associated with DM, PVD, cerebrovascular disease, & CV disease which could be due to inflammation. This is marked by loss of alveolar bone around teeth: Oral abx and chlorhexidine can slow it but may need root surface debridement. ■ 59% of those 60-69 and 72% of those 70+ have less than 20 teeth remaining which can impact nutritional status. Dentures does not decrease the malnutrition. ■ Dental caries is an infection. This can spread to other organs. The use of high- fluoride toothpaste can be beneficial. ■ Dental caries may be present or deterioration of dental restorations present. ■ Teeth may appear longer due to reabsorption of the gum and bone progresses which reveals the teeth root. ■ Dental malocclusion may be caused by the migration of remaining teeth after extractions. Normal: ■ The lips have increased vertical markings and appear dryer. ■ The buccal mucosa is thinner, less vascular, and less shiny ■ Tongue may appear more fissures, and veins on its ventral surface ■ Oral tissues may be dryer (xerostomia) esp with medications ■ Natural teeth may be worn down, shortening the crown, and altering enamel thickness. Exam finding with Otitis Media ○ Otitis media with effusion ■ Initial symptoms: sticking or cracking sound on yawning or swallowing; no signs of dizziness ■ Pain: discomfort, feeling of fullness ■ Discharge: none ■ Hearing: conductive loss as middle ear fills with fluid ■ Inspection: tympanic membrane retracted or bulging, impaired mobility, yellowish; air-fluid level and/or bubbles ○ Acute Otitis Media ■ Initial symptoms: abrupt onset, fever, feeling of blockage, anorexia, irritability ■ Pain: deep-seated earache that interferes with activity or sleep, pulling at ear ■ Discharge: only if tympanic membrane ruptures or through tympanostomy tubes; foul- smelling ■ Hearing: conductive loss as the middle ear fills with pus ■ Inspection: tympanic membrane with distinct erythema, thickened or clouding; bulging; limited or absent movement to positive or negative pressure, air-fluid level and/or bubbles

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NURS 612 AHA EXAM 1 (CHEN-WALTA REVIEW) (1)

, AHA Exam 1 (Chen-Walta review)

Normal and General: Abnormal: Normal:
Abnormal ● Chronic disease increases the burden ■ Gingivitis: which is associated with ■ The lips have increased
findings in of oral disease, predisposing older plaque, hormonal changes, or foreign- vertical markings and appear
elderly adults to oral microbial infections, pain, body response dryer.
mouth/pharynx altered taste, difficulty chewing and ■ Periodontal disease is associated with ■ The buccal mucosa is thinner,
speaking, and dysphagia. DM, PVD, cerebrovascular disease, & less vascular, and less shiny
● Poor oral health can lead to weight CV disease which could be due to ■ Tongue may appear more fissures,
loss inflammation. This is marked by loss of and veins on its ventral surface
○ Periodontal disease is the 6th leading alveolar bone around teeth: Oral abx ■ Oral tissues may be dryer
complication of diabetes and can inhibit and chlorhexidine can slow it but may (xerostomia) esp with medications
glycemic control and poor glycemic control need root surface debridement. ■ Natural teeth may be worn down,
can contribute to periodontal disease ■ 59% of those 60-69 and 72% of those shortening the crown, and
○ Xerostomia (dry mouth) impairs oral 70+ have less than 20 teeth remaining altering enamel thickness.
function, promotes tooth decay, which can impact nutritional status.
exacerbates periodontal disease which can Dentures does not decrease the
be caused by many medications. malnutrition.
■ Dental caries is an infection. This can
○ Oral cancer is the 8th most common
cancer in men and 7x more likely in older spread to other organs. The use of
high- fluoride toothpaste can be
adults
○ Aspiration pna is a major cause of beneficial.
■ Dental caries may be present or
hospitalization and results in 20-50%
deterioration of dental restorations
mortality, oral hygiene can decrease
present.
this incidence.
■ Teeth may appear longer due to
○ 23% have untreated cavities and
70& periodontal disease reabsorption of the gum and bone
○ 1/3 are fully edentulous (missing all progresses which reveals the teeth
root.
natural teeth) or average 19 or less
■ Dental malocclusion may be caused by
remaining teeth
○ 17% have orofacial pain, facial, oral the migration of remaining teeth after
extractions.
sores, burning mouth, and toothache
Exam finding ○ Otitis media with effusion ○ Acute Otitis Media
with Otitis ■ Initial symptoms: sticking or ■ Initialsymptoms: abrupt onset, fever, feeling of blockage, anorexia, irritability
Media cracking sound on yawning or ■ Pain: deep-seated earache that interferes with activity or sleep, pulling at ear
swallowing; no signs of dizziness ■ Discharge: only if tympanic membrane ruptures or through tympanostomy tubes;
■ Pain: discomfort, feeling of fullness foul- smelling
■ Discharge: none ■ Hearing: conductive loss as the middle ear fills with pus
■ Hearing: conductive loss as middle ■ Inspection: tympanic membrane with distinct erythema, thickened or clouding;
ear fills with fluid bulging; limited or absent movement to positive or negative pressure, air-fluid level
■ Inspection: tympanic membrane and/or bubbles
retracted or bulging, impaired mobility,

, bubbles

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