GERD

GERD

1. Pathopysiology

   • A chronic Syndrome
     • refulx of gastric contents into lower esophagus that causes damage to the mucosa
       • most common upper GI problem in adults

2. Nursing Diagnosis

   • Risk for aspiration
   • anxiety
   • sleep disturbance
   • acute Pin
   • knowledge deficit
   • imbalanced nutrition
   • risk for bleed

3. Clinical mainifistations

   • Heart Burn
     • After a meal
     • >2x/week
     • At NOC
       • wakes at NOC
   • Dyspepsia
     • pain centered in upper ABD
   • Regergitation
     • hot, bitter, sour liquid
   • respiratory s/s
     • Dyspnea
     • coughing
     • wheezing
     • Nocturnal cough
       • sleep disturbance
   • otolaryngologic s/s
     • Hoarseness
     • Sore throat
     • choking
     • lump in throat
   • Pain
     • chest
       • burning
       • squeezing
       • radiating
         • neck
         • jaw
         • arms
       • mimics angina
         • *Releived with antacids

4. Diagnostic studies

   • Barium Swallow
   • history & Physical exam
   • Upper GI endoscopy
     • LES conpetency
     • degree of inflammation
     • scarring strictures

5. Interprofessional care

   • surgery
   • dietician
   • gastroenterology
   • therapists

6. Nursing interventions

   • elevate HOB 30deg
   • sit up at least 2-3 hours after eating
   • avoid late NOC eating
   • Observe and monitor side effects and effectiveness of meds
   • Educate patient
     • Avoid causes
       • smoking
       • alcohol
       • caffeine
       • acidic foods
     • reduce stress
       • relaxation
         • meditation
         • music
         • warm bath
       • exercise
       • socialize
       • laugh
       • participate in hobby
     • weight reduction
   • Nutrition
     • frequent small meals
     • fluids between meals
     • avoid dairy at NOC
     • decrease high fat foods
     • avoid certain foods
       • peppermint
       • chocolate
       • orange juice
       • tomatoes
       • caffeine