NUR 2392 NUR2392 Multidimensional Care II MDC 2 Exam 3 Blueprint (Latest 2022/ 2023) Rasmussen

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