NURS 355 EXAM III: GERD ACTUAL QUESTIONS AND ANSWERS 2024 GRADED A+

NURS 355 EXAM III: GERD ACTUAL QUESTIONS AND ANSWERS 2024 GRADED A+ GERD stands for: Gastroesophageal Reflux Heartburn = pyrosis REMEMBER THAT GERD IS A CHRONIC SYMPTOM NOT A DISEASE Heartburn occurs when LES pressure is decreased. What medication provides quick relief of heartburn? Antacids What test would be used to assess LES competence and/or degree of inflammation in the esophagus? Endoscopy GERD can lead to two conditions: Esophagitis Barrett's syndrome What is GERD? Symptom in which acidified liquid content goes up into the esophagus, causing esophagitis Backflow of gastric contents into the esophagus due to the lower esophageal sphincter relaxing. What condition is this? GERD What foods/drinks can relax the lower esophageal sphincter and trigger GERD? Spicy foods Onions Citrus products Tomato products (e.g. ketchup) Fatty/fried foods Peppermint, chocolate Alcohol, caffeine What are the common symptoms for when a child has an acid reflux? Frequent vomiting Frequent cough Crying with feeding Heartburn, gas, abdominal pain Immature digestive system How to diagnose GERD? GE Reflux Scan. A scan in which the patient swallows a "tracer cocktail" How to treat GERD (non-pharmacological)? Elevate HOB Sleep: lie on left side Smoking cessation Maintain healthy weight Exercise (avoid crunches, sit-ups) Wear loose clothing Diet teaching for patients with GERD: Avoid chocolate, peppermint, alcohol, caffeine, fatty foods, smoking as they reduce the pressure in the lower esophageal sphincter, and promote reflux Interventions for patients with acute symptoms of GERD? 1. Elevate HOB 30 degrees, using 4 to 6 pillows 2. Avoid supine position after meals 3. Avoid foods that cause reflux Mechanism of action of antacids? (short duration) Neutralize stomach acid, so there is no acid to go up into esophagus. Relieve GI discomfort such as heartburn When should antacids be taken? 1-3 hours after meals A second dose two hours after a meal What are common side effects of GERD medications? Diarrhea Vomiting Gas Abdominal pain Drugs that are available over the counter? H2 blocker drugs Proton Pump Inhibitors (PPI): Must be taken on an empty stomach-- 1 hour before eating, take daily (e.g. before breakfast) Must be administered daily Adverse effects of PPI: Increased risk of bone fractures Avoid PPI in pregnant women, breastfeeding, and watch out for rebound hyperacidity H2 Blockers (histamine blocker) (long duration) Reduces gastric acid production., and can last up to 8 hours Diabetic patients, patients w/ gastric bypass or weight loss surgery, or at risk for B12 deficiency should watch out for these drugs: Chronic use of PPI's and H2 blockers What is Barrett's syndrome? A condition found in the lower part of the esophagus, caused by changes in cells/changes in esophageal lining due to presence of stomach acid The nurse is planning to teach a client with GERD about substances that will increase the lower esophageal sphincter (LES) pressure. Which item should the nurse include on this list? Nonfat milk Increase intraabdominal pressure can cause: Foods that INCREASE LES pressure = decreased reflux: Nonfat milk What decreases the LES to increase reflux? Coffee, tea/caffeine Chocolate, peppermint Fatty foods Tomatoes Anticholinergics Nicotine, alcohol Avoid milk at bedtime, as it increase gastric acid secretion The nurse is caring for a male client with a diagnosis of chronic gastritis. The nurse monitors the client knowing that this client is at risk for which vitamin deficiency? B12 deficiency Chronic gastritis leads to loss of function of parietal cells, which leads to loss of intrinsic factor The nurse has instructed the client who is experiencing diarrhea associated with irritable bowel syndrome on dietary changes to prevent diarrhea. The nurse knows the client understands the dietary changes if the client selects which of the following menu choices? Salad with chicken, whole wheat crackers Avoid dairy, high-fat foods, and carbohydrates because they increase diarrhea A client with gastroesophageal reflux disease complains about having difficulty sleeping at night, what should the nurse instruct the client to do? Sleep on several pillows in order to raise upper torso and minimize reflux of gastric contents The nurse explains to the patient with gastroesophageal reflux disease (GERD) that this disorder: Often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus, causing "heartburn" What is the best test to use to assess mucosal injury in the esophagus? Upper endoscopy Avoid or reduce acidic beverages such as: Colas Red wine Orange juice How to PREVENT reflux? Eating smaller, frequent meals throughout the day and limit fluids to prevent distention of stomach How to prevent gastric distention 1. Eat smaller, frequent meals 2. Avoid late evening meals 3. Take fluids between meals rather than with meals The nurse is assessing the client diagnosed with chronic gastritis. Which symptom(s) support this diagnosis? Epigastric pain relieved by eating food What signs and symptoms would indicate that a patient has GERD? Pyrosis, water brash, and flatulence Pyrosis= heartburn Water brash= feeling of saliva secretion The client attends two sessions with the dietitian to learn about diet modifications to minimize gastroesophageal reflux. The teaching would be considered successful if the client says that she will decrease her intake of which of the following foods? Fats/fatty foods The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement? Monitor IV fluids Which statement made by the client indicates to the nurse the client may be experiencing GERD? "I take antacid tablets with me wherever I go." Frequent use of antacids may indicate a reflux problem A nurse is caring for a client diagnosed with ulcerative colitis. The nurse recognizes that an expected outcome of the medical regimen has been achieved when which of the following occurs? The client maintains an ideal body weight Pain during that night that is often relieved by eating food. What is this? Duodenal ulcer Non-bloody diarrhea Crohn's disease The client with gastroesophageal reflux disease (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? Aspiration of gastric contents Patient's with GERD can develop pulmonary symptoms such as: Coughing Wheezing Dyspnea All of these are all caused by aspiration The nurse is teaching the patient with a peptic ulcer discharge instructions. The client asks the nurse which type of analgesic he may take. Which of the following responses by the nurse would be most accurate? Acetaminophen because it does not irritate the mucosa. Avoid NSAIDS such as aspirin, as they may cause irritation 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? Eating small frequent meals, and remain upright for atleast 30 minutes after eating A nurse provides feeding instructions to a mother of an infant diagnosed with gastroesophageal reflux disease. To assist in reducing the episodes of emesis, the nurse tells the mother to: Thicken the feedings by adding rice cereal to the formula can reduce episodes of vomiting (emesis) The male client tells the nurse he has been experiencing "heartburn" at night that awakens him. Which assessment question should the nurse ask? What have you done to alleviate the heartburn? Know what OTC medications that the patient may have taken prior to showing up at the clinic