Gastroesophageal

Gastroesophageal Gastroesophageal - Start

2017-10-10 47K 47 0 0

Description

Reflux Disease. (GERD). OBJECTIVES. Understand the basic pathophysiology of GERD. Identify the symptoms of GERD. Understand proper medical and nursing interventions. PATHOPHISIOLOGY. Caused by the relaxation of the lower esophageal sphincter (LES). ID: 594842 Download Presentation

Embed code:
Download Presentation

Gastroesophageal




Download Presentation - The PPT/PDF document "Gastroesophageal" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.



Presentations text content in Gastroesophageal

Slide1

Gastroesophageal Reflux Disease(GERD)

Slide2

OBJECTIVES

Understand the basic pathophysiology of GERD

Identify the symptoms of GERD

Understand proper medical and nursing interventions

Slide3

PATHOPHISIOLOGY

Caused by the relaxation of the lower esophageal sphincter (LES)

Gastric juices move back through the LES into the esophagus

Can cause erosion of the esophageal mucosal layer

http://www.youtube.com/watch?v=o8iShP84HP4

(

Nowkediuko

, 2012)

Slide4

SYMPTOMOLOGY

Heartburn

Regurgitation

Sleep disturbances

Cough

Hoarseness

Asthma

Dental erosions

(

Nowkediuko

, 2012)

Slide5

PREVALANCE

Most common upper gastrointestinal disease in western countries

10%-20% of people in western countries experience symptoms

8.9 million people diagnosed (Perry, 2012)

Seen mostly in older Caucasian males

(

Nowkediuko

, 2012)

Slide6

RISK FACTORS

Genetic factor

Obesity

Alcohol abuse

Smoking

(

Nowkediuko

, 2012)

Slide7

MEDICAL INTERVENTIONS

Acid Suppressive Therapy

Histamine 2 receptor antagonists (H2RAs)

Proton pump inhibitors (PPI)

Antacids

Surgery

Transoral

incisionless

fundoplication

Nissen’s

fundoplication

(

Nowkediuko

, 2012)

Slide8

NURSING INTERVENTIONS

Pain management

Assess pain level frequently

Administer

medications

Risk for aspiration

Monitor respiratory rate, depth, and effort

When eating look for signs of aspiration including coughing, choking, and spitting food

(Ackley, 2010)

Slide9

PATIENT TEACHING

For patients that are obese encourage weight loss.

Avoid alcohol, chocolate, citrus juice, tomato-based products, peppermint, coffee, and onion.

Smaller sized meals more frequently throughout the day.

(

Nowkediuko

, 2012)

Slide10

PATIENT SCENARIO- HPI

The patient is a 58 year-old white female who complains of

gastroesophegeal

reflux. She states that the esophageal reflux began approximately 10 years ago and had

nissen

fundoplication surgery to fix the problem. Esophageal reflux pain began again 8 months ago in the stomach, esophagus, and back. Patient reports pain as constant, burning, and an 8/10 on 0/10 scale. Tried 4-5 different medications, none made her symptoms better. Symptoms worsened after eating.

Slide11

PATIENT MEDICATIONS

LovenoxInsulinDilaudidPhenol topical (chloraseptic spray)Patient was not taking any acid suppressive therapy medication or antacids to relieve symptoms

http://www.adultmeducation.com/images/Overview.jpg

Slide12

LABS AFTER SURGERY

Glucose 155 (higher than normal range)

After surgery glucagon can be released from the pancreas with decreased production of

insulin

HGB 10.8, HCT 34.0 (lower than normal range)

Hemoglobin and hematocrit values are commonly low after surgery

WBC 7.4, PLT 217 (within normal range)

Indicates no infection

Slide13

PATIENT SCENARIO- INTERVENTIONS

Medical

Transoral

incisionless

fundoplication

Nursing

Pain control with medication

Increasing comfort of patient by adjusting bed to comfortable position

Slide14

NURSING DIAGNOSIS

Pain r/t recent surgery

a.e.b

patient complaints of pain 5/10 and grimacing

Impaired swallowing r/t pain from recent surgery

a.e.b

grimacing while swallowing

Risk for imbalanced nutrition r/t difficulty swallowing and lack of desire to eat

Slide15

NCLEX QUESTIONS 1

Gastroesophageal

reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions?

 

A. Decrease

daily intake of vegetables and water, and ambulate

frequently

B. .Drink

coffee diluted with milk at each meal, and remain in an upright position for 30 minutes

.

C. Eat

small, frequent meals, and remain in an upright position for at least 30 minutes after eating

.

D. Avoid

over-the-counter drugs that have antacids in them

.

Tabloski

, P. B. (2010). NCLEX review questions. Retrieved from http://

wps.prenhall.com

/chet_tabloski_gerontolog_1/40/10305/2638168.cw/ content/

index.html

Slide16

NCLEX QUESTION 2

Which

of the following foods should be avoided by clients who are prone to develop heartburn as a result of

gastroesophgeal

reflux disease (GERD)?


A.

    Lettuce


B.

    Eggs


C.

    Chocolate


D.

   

Butterscotch

Basic care and comfort

nclex

practice test. (2010, July 22).

Retrieved from

http

://nclexreviewers.com/nclex-sample-questions/basic-care-and

- comfort

/basic-care-and-comfort-

nclex

-practice-

test.html

Slide17

NCLEX QUESTION 3

The

client with GERD complains of a chronic cough. The nurse understands that in a client with GERD this symptom may be indicative of which of the following conditions?

A. Development

of laryngeal cancer

B. Irritation

of the esophagus

C.Esophageal

scar tissue formation

D. Aspiration

of gastric

contents

Student nursing study blog [Web log message] . (2010). Retrieved

from

http

:/

/ amy47

.com/

nclex

-style-practice-questions/gastro/gastro-3/

Slide18

NCLEX QUESTION 4

The surgical procedure of choice for older patients with GERD and Barrett's esophagus that is not reversible with medical management is:

Esophagectomy

.

Nissen’s

fundoplication

Tota

laryngectomy

.

Labyrinthectomy

.

Tabloski

, P. B. (2010). NCLEX review questions.

Retrieved

from http

:/

/

wps.prenhall.com

/chet_tabloski_gerontolog_1/40/10305/2638168.cw

/ content

/

index.html

Slide19

NCLEX QUESTION 5

The RN has finished teaching a patient about treatment of GERD. The RN knows the patient has understood the teaching if she states:

A.

    “I should eat a small bedtime snack each night.”


B.

    “I should lie flat in bed.”


C.

    “I can have red wine with dinner.”


D.

    “I should eat six small meals daily.

Physiological adaptation

nclex

RN practice test. (2010, August 23).

Retrieved

from http

://

nclexreviewers.com

/

nclex

-sample-questions/physiological

- adaptation

/physiological-adaptation-

nclex

-

rn

-practice-

test.html

Slide20

REFERENCES

Ackley, B. J.,

Ladwig

, G. B. (2011). Nursing diagnosis handbook. St. Louis, MO: Mosby

Elsevier

Basic care and comfort

nclex

practice test. (2010, July 22). Retrieved from

http://nclexreviewers.com/nclex-sample-questions/basic-care-and-

comfort/basic-care-and-comfort-

nclex

-practice-

test.html

Nowkediuko

, S. C., (2012, July 11). Current trends in the management of

gastroesophageal

reflux: a review.

ISRN

Gastroenterol

, 2012

.

doi

:

10.5402/2012/

391631

Peery

, A.F., &

Dellon

, E. S. (2012, November). Burden of gastrointestinal disease in the

United

States: 2012 update.

Gastroenterology

, 143(5): 1179-1187.

doi

:

10.1053

/j.gastro.2012.08.002

.

Physiological adaptation

nclex

RN practice test. (2010, August 23). Retrieved from

http

://

nclexreviewers.com

/

nclex

-sample-questions/physiological- adaptation/physiological-adaptation-

nclex

-

rn

-practice-

test.html

Student nursing study blog [Web log message] . (2010). Retrieved from http:// amy47.com/

nclex

-style-practice-questions/gastro/gastro-3

/

Tabloski

, P. B. (2010). NCLEX review questions. Retrieved from http://

wps.prenhall.com

/chet_tabloski_gerontolog_1/40/10305/2638168.cw/ content/

index.html


About DocSlides
DocSlides allows users to easily upload and share presentations, PDF documents, and images.Share your documents with the world , watch,share and upload any time you want. How can you benefit from using DocSlides? DocSlides consists documents from individuals and organizations on topics ranging from technology and business to travel, health, and education. Find and search for what interests you, and learn from people and more. You can also download DocSlides to read or reference later.