GERD Flashcards
1
Q
What is GERD?
A
Chronic disorder, acid reflux from the stomach into the esophagus causing tissue damage
2
Q
Risk Factors for GERD
A
Hiatal Hernia, LES hypotension, loss of esophageal motility, increased compliance of the hiatal canal, increased states of gastric secretion, eating large meals, obesity, pregnancy, ascites, tight belts or girdles, presence of NG
3
Q
Manifestations
A
- Heartburn
- Regurgitation
- Atypical Chest Pain
- Odynophagia (painful swallowing)
- Hemorrhage
- Dental Caries
- Aspiration Pneumonia
- Chronic cough
- Morning hoarseness
- Adult onset asthma
- Laryngitis, pharyngitis, & bronchitis
4
Q
Diagnostics
A
- 24 hour esophageal pH monitoring, catheter placed through the nose that monitors gastric pH
- EGD
- Esophageal manometry (motility test, reads LES Pressure and peristalsis)
5
Q
Medications
A
- Antacids (increase gastric pH)
- Histamine receptor antagonists (decrease gastric acid production; short acting)
- Pro kinetic Medications (increase gastric empyting)
- Proton pump inhibitors (decrease gastric acid production; long acting)
6
Q
Medication Reminders
A
- Long-term use of PPIs: associated with hip fractures
- Long-term use of Metoclopramide (reglan) associated with tardive dyskinesia
7
Q
Major complications
A
- Barrett’s Esophagus
8
Q
Nursing Diagnoses Ex.
A
- Acute/chronic pain related to physical injury as evidenced by esophageal irritation
- Risk for aspiration related to inadequate LES function
9
Q
Nursing Assessments
A
- Respiratory symptoms (aspiration with acid reflux)
- Regurgitation
- Chest pain (rule out HA)
- Hemorrhage (Erosion and necrosis of the esophagus from acid)
- CBC (decreased H&H)
- Dyspepsia
- Dysphagia & odynophagia
- Signs of Barrett’s esophagus
- Dental carries (acid breaks down tooth enamel and decay)
- Water Brash
- Eructation, Flatulence, or bloating
- Nausea
10
Q
Medications
A
- Antacids (neutralize or buffer stomach acid)
- Histamine receptor agonists (acid production is decreased)
- Proton pump inhibitors (acid production is blocked)
- Pro-kinetic (gastric emptying is increased (REGLAN))
11
Q
Nursing management
A
- Position patient on right side with HOB elevated 30-45 degrees (promotes gastric emptying and peristalsis)
- Provide 4-6 meals per day
12
Q
Patient Education
A
- Limit spicy/fatty goods, caffeine, chocolate, carbonation, acidic foods, peppermint, alcohol, and certain medications (calcium channel blockers, anticholinergic meds, & smooth muscle relaxers)
- Avoid smoking and alcohol
- Avoid NSAIDs and Aspirin
- Encourage patient to wait at least 2 hours after eating to lay down
- Encourage less restrictive clothing
- Educate about ideal body weight
