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Exam 4 > Gastroesophageal Reflux > Flashcards

Gastroesophageal Reflux Flashcards

1
Q

How is Gastroesophageal reflux described?

A

Backward flow of gastric contents into esophagus resulting in heartburn

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2
Q

What is gastroesophageal reflux a sign of

A

Poor digestion

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3
Q

What percentage of adults experience gastroesophageal reflux?

A

15-20%

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4
Q

What are the two ways a client with gastroesophageal reflux will present ?

A

Asymptomatic or inflammatory esophagitis

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5
Q

What typically helps maintain the pressure differences of the stomach and esophagus?

A

the location of the gastroesophageal junction below the diaphragm

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6
Q

What are the three types of etiology that can result in a paitent having gastroesophageal reflux?

A
  • Transient reaction of lower esophageal sphincter
  • incompetent lower esophageal sphincter
  • Increased pressure within the stomach
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7
Q

What are the contributing factors of gastroesophageal reflux?

A
  • Increased gastric volume
  • Certain body positions
  • Pressure from obesity or tight clothing
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8
Q

What are the risk factors of gastroesophageal reflux?

A

-Obesity
-Older age
-Excessive alcohol consumption
-Smoking
-Hiatal hernia
-Diabetes
-Pregnancy
Diet

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9
Q

What types of foods can contribute to gastroesophageal reflux?

A
  • Fatty/fried foods
  • Chocolate
  • Caffeine
  • Citrus
  • Peppermint
  • Spicy foods
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10
Q

What are the clinical manifestations of gastroesophageal reflux in infants?

A

Spit up or forceful vomiting

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11
Q

What are the clinical manifestations of gastroesophageal reflux in adults?

A
  • Heartburn after eating, bending over, reclining
  • Cough
  • Flatulence
  • Excessive belching
  • Hoarseness
  • Pain in swallowing
  • Regurgitation of sour material into mouth
  • Atypical chest pain
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12
Q

What are the clinical manifestations of gastroesophageal reflux in children?

A
  • Poor weight gain
  • Recurrent vomiting
  • Irritability
  • Poor feeding
  • Arching of the back
  • Sore throat
  • Asthma
  • Respiratory involvement
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13
Q

What are the complications with gastroesophageal reflux?

A
  • Erosive esophagitis
  • Esophageal strictures
  • Barrett’s esophagitis
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14
Q

Esophageal strictures may lead to what?

A

Dysphagia

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15
Q

What are the 4 things to avoid when trying to prevent gastroesophageal reflux?

A

Avoid:

  • Foods that stimulate acid production
  • Eating close to bedtime
  • Tight-fitting clothing
  • Smoking and alcohol
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16
Q

In order to prevent gastroesophageal reflux what should you do?

A
  • Eat smaller more frequent meals
  • Elevate head of bed to reduce pressure on lower esophageal sphincter
  • Maintain near or ideal body weight
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17
Q

What are the diagnostic tests for gastroesophageal reflux?

A
  • Barium swallow
  • Upper endoscopy
  • Bernstein test
  • 24-hour ambulatory pH monitoring
  • Esophageal manometry
  • EGD
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18
Q

What are the types of pharmacologic therapies for gastroesophageal reflux?

A
  • Antacids
  • H2 receptor blockers
  • Proton pump inhibitors
  • Promotility agents
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19
Q

What is the drug of choice for severe GERD?

A

Omeprazole

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20
Q

What class does sodium bicarbonate belong to?

A

Antacid

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21
Q

What is sodium bicarbonate used for?

A

Mild to moderate symptoms of GERD

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22
Q

What class does famotidine belong to?

A

H2 receptor blockers

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23
Q

What class does Omeprazole belong to?

A

Proton pump inhibitor

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24
Q

What class does metoclopramide belong to?

A

Promotility agents

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25
Q

What is the mechanism of action for sodium bicarbonate?

A

Neutralizes stomach acid by raising pH of stomach contents

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26
Q

What is the primary use for sodium bicarbonate?

A

Relief of upset stomach associated with hyperacidity

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27
Q

What are the adverse effects of sodium bicarbonate?

A

Metabolic alkalosis
Constipation
Diarrhea

28
Q

What are the routes that sodium bicarbonate can be given?

A

Oral and IV

29
Q

What is the onset for oral sodium bicarbonate?

A

Rapid

30
Q

What is the onset for IV sodium bicarbonate?

A

Immediate

31
Q

What is the peak for Oral Sodium Bicarbonate?

A

30 minutes

32
Q

What is the peak of IV sodium Bicarbonate?

A

Rapid

33
Q

What is the duration for oral sodium bicarbonate?

A

1-3 hours

34
Q

What is the duration for IV sodium bicarbonate?

A

Unknown

35
Q

What is the role of the nurse in terms of Antacid therapy?

A

To assess the patients use of over the counter formulas

36
Q

IF a patient is using over the counter formulas for antacid therapy when should they seek medical attention?

A

If the symptoms persist or reoccur

37
Q

What could persistent epigastric pain or heart burn be a symptom of?

A

More serious disease

38
Q

What class does famotidine belong to?

A

H2 receptor blockers

39
Q

What is the mechanism of action for Famotidine?

A

Acts by blocking H2 receptors in stomach to decrease acid production

40
Q

What is the primary use for Famotidine?

A

To treat peptic ulcer disease (GERD)

41
Q

Where does Famotidine effect in the body?

A

The liver and kidneys

42
Q

What are the adverse effects of Famotidine?

A
  • Dizziness
  • Confusion
  • Thombocytopenia
  • Increases BUN/creatinine
43
Q

Long-term use of Omeprazole is associated with what?

A

Increased risk of gastric cancer and hip fractures

44
Q

What class does Omeprazole belong to?

A

Proton Pump Inhibitor

45
Q

What is the mechanism of action for Omeprazole?

A

Reduces acid secretion in stomach by binding irreversibly to enzyme H1, K1-ATPase

46
Q

What is the primary use for Omeprazole?

A

A therapy for peptic ulcers and GERD (2-6 months)

47
Q

What are the adverse effects of Omeprazole?

A
  • Headache
  • Nausea
  • Diarrhea
  • Rash
  • Abdominal pain
48
Q

What is the route omeprazole is given?

A

Oral

49
Q

What is the onset of omeprazole?

A

Varies

50
Q

What is the peak of omeprazole?

A

0.5-3.5 hours

51
Q

What is the duration of omeprazole?

A

Varies

52
Q

If an infant has GERD what may happen to it?

A

They may outgrow it

53
Q

What are the pediatric manifestations of GERD?

A
  • Coughing
  • Difficulty swallowing
  • Asthma symptoms
  • Periods of apnea
  • Frequent upper respiratory infections
54
Q

What may help reduce symptoms and long-term effects of GERD?

A

Dietary and lifestyle changes

55
Q

What is the next option for a patient with GERD that is unresponsive to pharmacologic and lifestyle interventions?

A

Surgery

56
Q

What two types of surgeries can be done to help a patient with GERD?

A
  • Laparoscopic fundoplication

- Nissen fundoplication

57
Q

What is the choice surgery for GERD patients?

A

Laparoscopic fundoplication

58
Q

What should the nurse focus on in GERD patients?

A

Alleviating symptoms and client education

59
Q

What health history assessment should be done for GERD patients?

A
  • Heartburn
  • Atypical chest pain
  • Types of food tolerance
  • Regurgiation
  • Symtoms r/t positioning
60
Q

What is the physical assessment to be done on a GERD patient?

A

epigastric tenderness

61
Q

What are the three diagnoses for a patient with GERD?

A
  • Ineffective Health Maintenance
  • Acute Pain
  • Dysfunctional Gastrointestinal Motility
62
Q

What is the nurses priority when treating a GERD patient?

A

Relieve the discomfort associated with the disease

63
Q

What should the nurse focus her teaching on with a patient with GERD?

A
  • Preventing symptoms

- Long-term consequences of disorder

64
Q

What should the nurse implement when treating a GERD patient?

A
  • Provide client education to reduce pain, make long term lifestyle changes
  • Refer client to smoking cessation program
  • Administer medications as ordered
  • Encourage client’s continued use of pharmacologic therapy even after symptoms improve
65
Q

What evaluations should a nurse have with a patient who has GERD?

A
  • Client expresses freedom from heartburn
  • Client is free from pain
  • Client verbalizes knowledge of GERD, appropriate diet, lifestyle changes
  • Client demonstrates ability to manage symptoms

Exam 4 (13 decks)

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