What is the most common presenting complaint in patients with GERD?
Burning in lower part of mid-chest
Which of the following can double your risk of developing GER/D?
Which of the following is best described as being characterized by a reparative process in which the squamous mucosa that normally lines the esophagus is gradually replaced by columnar epithelium resembling that in the intestines and stomach?
You are doing some teaching with a patient who has GERD. Which of the following statements would be incorrect?
"Eat slowly and chew thoroughly to add saliva to your food."
"Eat only two or three meals a day that are rich in carbohydrates and low in protein."
"Don't eat or drink 2-3 hours before bedtime to prevent heartburn at night (nocturnal reflux)."
"Avoid foods that reduce the muscle tone of the opening between your throat and stomach (lower esophageal sphincter) (e.g. chocolate, fatty foods)."
Aaron Huntley, 46, comes to your clinic complaining of dull, burning pain in his stomach. He tells you that it typically occurs 2 to 3 hours after meals and during the night and is relieved only by eating or taking an antacid. He says he doesn't have nausea or vomiting. What condition do you suspect that Mr. Huntley has?
PUD, with duodenal ulcers
PUD, with gastric ulcers
______ ulcers are more prevalent in the older age group, whereas ______ ulcers occur at any age and are frequently seen in early adulthood.
Which of the following is the major cause of peptic ulcer disease?
Infection with helicobacter pylori
Chronic use of NSAIDs
Helicobacter pylori is a small, curved, gram negative bacillus.
How is it that H. pylori is able to survive in the acidic environment of the stomach?
They secrete urease, which enables them to produce sufficient ammonia to buffer the acidity of their immediate environment
They secrete a toxin that damages the parietal cells in the stomach and inhibits release of gastric acid
They infect host cells that transport the bacteria into the stomach
Helicobacter pylori thrive in an acidic environment
All people infected with helicobacter pylori will develop peptic ulcer disease.
Patients with duodenal ulcers usually have normal appetites, whereas patients with gastric ulcers usually present with nausea and vomiting of undigested food.
Which of the following tests are avoided in diagnosis of peptic ulcer disease due to its high false positive test rate?
Urea breath test
Serologic test for antibodies
Stool sample to test for occult blood
Which type of shock would a patient with peptic ulcer disease be most likely to develop?
How would a patient present if they had peritonitis, secondary to peptic ulcer disease? Select all that apply.
Severe, acute abdominal pain radiating throughout abdomen and shoulder
No bowel sounds
GERD is a result of...
an excessive production of hydrochloric acid
a zone of low pressure of the lower esophageal sphincter
the presence of helicobacter pylori in the esophagus
a reverse muscular peristalsis of the esophagus
In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions?
Decrease daily intake of vegetables and water and ambulate frequently
Drink coffee diluted with milk at each meal and remain in an upright position for 30 minutes after eating
Eat small, frequent meals and remain in an upright position for 30 minutes after eating
Avoid over-the-counter drugs that have antacids in them
The primary cause of duodenal ulcers is...
hypersecretion of gastric acid
hyposecretion of gastric acid
A peptic ulcer may occur in any of the following except: