Galen NUR 242 Exam 3 Streb notes
GERD Risk factors include
Consumption of foods such as caffeine, alcohol, spicy or fried foods, chocolate, and tomatoes. Lifestyle factors play a big part especially alcohol and smoking.
GERD the nursing assessment should include
asking about a history of hear...
Galen NUR 242 Exam 3 Streb notes
GERD Risk factors include
Consumption of foods such as caffeine, alcohol, spicy or fried foods, chocolate, and
tomatoes. Lifestyle factors play a big part especially alcohol and smoking.
GERD the nursing assessment should include
asking about a history of heartburn or atypical chest pain associated with the reflux of
GI contents.
GERD manifests differently depending on
the patient and the severity of the disorder
GERD most common symptoms
-Heartburn (pyrosis)
-Dyspepsia (Indigestion)
(May be described as substernal burning moving up and down the chest)
GERD pain usually develops within
30-60 minutes after meals
Severe heartburn pain can radiate to the neck, jaw, or back and patients may think they
are having an MI
GERD symptoms are exacerbated when
lying down flat or bending over
GERD regurgitation may lead to
Aspiration or bronchitis
These patients are at risk of aspirating when lying flat
Symptoms of GERD include
Coughing or wheezing at night, dysphagia, belching and nausea, hoarseness, and
insomnia. Assess lungs for presence of crackles.
Hiatal Hernia
A condition where a part of the stomach that normally is located in the abdominal cavity
protrudes through the esophageal hiatus to rest within the chest cavity
Hiatal Hernia symptoms usually worsen after meals. These symptoms may be
made worse when
Lying flat and may resolve with sitting up or walking.
Hiatal Hernia patients should immediately report
abdominal pain with nausea, vomiting, and fever
Hiatal Hernia lifestyle changes may include
elevating the head of the bed when sleeping to allow gravity to prevent acid from
refluxing into the esophagus and remaining upright after meals.
Hiatal hernia Diet should consist of
small frequent meals instead of eating two or three larger meals a day. Avoid vigorous
movement after meals.
Hiatal hernia foods that should be avoided include
spicy, greasy foods, onions, tomatoes and citrus fruits
, Gastritis occurs when
the lining of the stomach known as the mucosa becomes inflamed or swollen. When the
stomach mucosa becomes inflamed edema, hemorrhage and erosion of the mucosa
occur.
Medical treatment for Gastritis depends on the specific cause. Patients will be
instructed to stop taking irritating medications such as
ASA and NSAIDS
Gastritis medications to decrease the amount of hydrochloric acid in the
stomach. these would include
Antacids, H2 antagonists, and Proton pump inhibitors
The patient with Gastritis is at risk for
Deficient Fluid Volume
A nursing priority is to access the patient's hydration status. Includes I&O, Daily
Weights, &VS.
Peptic Ulcers Disease
are a break in the mucous lining of gastrointestinal tract from continued contact with
gastric juice. This results in inflammation. Pain that is worsened by the ingestion of food.
Ulcers in the mucosa of GI tract occur from several different causes. Duodenal
ulcers are associated with a
H. Pylori infection
Gastric ulcer pain is described as
a dull, aching pain, often right after a meal; eating does not relieve pain and may even
worsen it. Pain may also occur late at night.
Other symptoms associated with PUD are
Nausea with or without vomiting, weight loss, anorexia, belching and dyspepsia
(indigestion). Patient may report a distended abdomen that is painful.
PUD increased risk factor in
Smokers
smoking contributes to the pathogenesis of peptic ulcer disease. Smoking causes an
acceleration of gastric emptying of liquids, promotes of duodenogastric reflux and
causes a reduction in mucosal blood flow. Patient should attend a smoking cessation
course.
Gastric Cancer
Stomach cancers tend to develop slowly over many years. Before a true cancer
develops, pre-cancerous changes often occur in the inner lining (mucosa) of the
stomach. These early changes rarely cause symptoms and therefore often go
undetected
The decline of stomach acids has been linked to the frequent use of antibiotics to
treat infection. Antibiotics can kill the bacteria called
Helicobacter pylori (H. pylori), which is though to be a major cause of stomach cancer
Gastrectomy post care
Administer protein and vitamin supplements to foster wound repair and tissue building.
Eat small, frequent meals.
Stress the importance of long term vitamin B12 injections after
gastrectomy to prevent surgically induced pernicious anemia
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