Author Question: A patient with severe esophageal spasms is diagnosed with achalasia. For which surgical procedures ... (Read 34 times)

Deast7027 · **on:** Jun 25, 2018

A patient with severe esophageal spasms is diagnosed with achalasia. For which surgical procedures should the nurse prepare teaching for this patient?

Select all that apply.

1. esophagectomy
2. gastric resection
3. laparoscopic myotomy
4. balloon dilation of the lower esophageal sphincter
5. endoscopically guided injection of botulinum toxin

Question 2

A 32-year-old patient receiving chemotherapy for breast cancer is prescribed aprepitant (Emend). What should the nurse emphasize when teaching the patient about this medication?

Select all that apply.

1. Take this medication for 10 days.
2. Take the medication either with food or on an empty stomach.
3. Use a barrier contraceptive while taking this medication.
4. A skin rash is an expected effect of this medication.
5. Contact the healthcare provider about any onset of confusion.

Moriaki · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 3, 4, 5
Treatment of achalasia may include endoscopically guided injection of botulinum toxin into the lower esophageal sphincter or balloon dilation of the LES. Botulinum toxin injection lowers LES pressure, but may need to be repeated every 6 to 9 months. Balloon dilation tears muscle fibers in the LES, reducing its pressure. A laparoscopic myotomy reduces pressure and relieves symptoms. An esophagectomy is indicated for esophageal cancer. Gastric resection is indicated for gastric cancer.

Answer to Question 2

Correct Answer: 2, 3, 5
This medication can be taken with food or on an empty stomach. The patient should use barrier contraception while taking this drug because oral contraceptives will be less effective. Confusion is an adverse effect and should be reported to the healthcare provider. This medication should be taken for 3 days. A skin rash is an adverse effect and should be reported to the healthcare provider.