NSG320 Study Questions solved 100% Correct
GERD
Damage caused by reflux of stomach acid into the LE
Cause obesity, food, drugs, Incompetent LES(MC)- occurs when patient is supine or increased
and pressure
Food affecting
- chocolate, fatty foods, peppermint, tea, coffee
S/S
- pyrosis, dyspepsia(chest pain)- relived by antacid
- regurgitation
Can mimic angina or HA, pts freak
Complications of GERD
Esophagitis
- due to repeated esophagitis may lead to scar tissue formation
Chronic gerd (barrett esophagus)
- metaplasia, precancerous
Dental erosion
- posterior teach, from acid reflux
Nursing management of Gerd
- Lifestyle modifications
( balanced diet, small frequent meals, Drink between meals!
,low fat
Concerned if GERD >2wks
HOB>30degrees
Avoid reflux foods
(coals, red wine, OJ)
no late night meals (3hrs)
Sit up for 2hrs after eating
No dairy, no chewing gum
Medication
- PPI( day, taken BEFORE meals), promote esophagus healing
- Only taken for short amount of time
( decreases B12, mg, increased risk for kidney disease, and bone fractures)
H2
- Ranitidine
- onset is 1hr, lasts for 12hr
Antacids
- take AFTER food, increases effects
(magnesium hydroxide or aluminum hydroxide
last 2-30min
- MOST effective taken 1-3hrs after food or at night
-only should be given hourly
Prokinetics
,(improves the LES pressure
- aiding it to close better
Patient and Caregiver teaching for GERD
Low fat diet
- Eat small frequent meals to prevent gastric distention
- drink water in between meals
STOp smoking
Do not lie down for 2-3hrs after eating, do NOT wear tight clothing
- DO not bend over esp after eating
- reduce weight
Nutrition therapy
- Eat e\less irritant foods
(Chocolate, fatty foods, peppermint, coffee, tea_
- tomato based ( OJ, red win, soda)
Small frequent meals and fluids between meals
Gum and oral lozenges may help with mild symptoms
Hiatal Hernia
Portion of stomach herniates through diaphragm (squeezing the stomach)
Often asymptomatic, but presents as GERD (like)
ME- strangulation ( due to weakness of the diaphragmatic muscles)
, S/S
- pyrosis(HB), dyspepsia(CP), and regurgitation)
Complications of Hiatal hernia
- Stenosis
- ulceration
- strangulation
- regurgitation with aspiration
Dx- Barium swallow test
Nursing management for Hiatal Hernia
Elevation HOB>30
avoid gastric irritation foods
(chocolate, peppermint, coffee, red wine, OJ, tomato paste, tea )
- no tight cloths
No acidic pH beverages
PPI, H2, Prokinetics, Antacid
Esophageal cancer
Ulcerated hernia that eats away of the esophagus, or grows in the esophagus
S/S(risk for dehydration/malnourishment)
- hoarse voice, dysphagia, pain, bleeding tumors, unintentional weight loss
Dx
- Endoscopy with biopsy
Tx
- dependent on tumor location
Health promotion
GERD
Damage caused by reflux of stomach acid into the LE
Cause obesity, food, drugs, Incompetent LES(MC)- occurs when patient is supine or increased
and pressure
Food affecting
- chocolate, fatty foods, peppermint, tea, coffee
S/S
- pyrosis, dyspepsia(chest pain)- relived by antacid
- regurgitation
Can mimic angina or HA, pts freak
Complications of GERD
Esophagitis
- due to repeated esophagitis may lead to scar tissue formation
Chronic gerd (barrett esophagus)
- metaplasia, precancerous
Dental erosion
- posterior teach, from acid reflux
Nursing management of Gerd
- Lifestyle modifications
( balanced diet, small frequent meals, Drink between meals!
,low fat
Concerned if GERD >2wks
HOB>30degrees
Avoid reflux foods
(coals, red wine, OJ)
no late night meals (3hrs)
Sit up for 2hrs after eating
No dairy, no chewing gum
Medication
- PPI( day, taken BEFORE meals), promote esophagus healing
- Only taken for short amount of time
( decreases B12, mg, increased risk for kidney disease, and bone fractures)
H2
- Ranitidine
- onset is 1hr, lasts for 12hr
Antacids
- take AFTER food, increases effects
(magnesium hydroxide or aluminum hydroxide
last 2-30min
- MOST effective taken 1-3hrs after food or at night
-only should be given hourly
Prokinetics
,(improves the LES pressure
- aiding it to close better
Patient and Caregiver teaching for GERD
Low fat diet
- Eat small frequent meals to prevent gastric distention
- drink water in between meals
STOp smoking
Do not lie down for 2-3hrs after eating, do NOT wear tight clothing
- DO not bend over esp after eating
- reduce weight
Nutrition therapy
- Eat e\less irritant foods
(Chocolate, fatty foods, peppermint, coffee, tea_
- tomato based ( OJ, red win, soda)
Small frequent meals and fluids between meals
Gum and oral lozenges may help with mild symptoms
Hiatal Hernia
Portion of stomach herniates through diaphragm (squeezing the stomach)
Often asymptomatic, but presents as GERD (like)
ME- strangulation ( due to weakness of the diaphragmatic muscles)
, S/S
- pyrosis(HB), dyspepsia(CP), and regurgitation)
Complications of Hiatal hernia
- Stenosis
- ulceration
- strangulation
- regurgitation with aspiration
Dx- Barium swallow test
Nursing management for Hiatal Hernia
Elevation HOB>30
avoid gastric irritation foods
(chocolate, peppermint, coffee, red wine, OJ, tomato paste, tea )
- no tight cloths
No acidic pH beverages
PPI, H2, Prokinetics, Antacid
Esophageal cancer
Ulcerated hernia that eats away of the esophagus, or grows in the esophagus
S/S(risk for dehydration/malnourishment)
- hoarse voice, dysphagia, pain, bleeding tumors, unintentional weight loss
Dx
- Endoscopy with biopsy
Tx
- dependent on tumor location
Health promotion
