GERD Symptoms and Patient Teaching

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Questions and Answers

What is a common symptom of GERD?

Increased appetite

Dyspepsia (correct)

Flapping of hands

Weight gain

What medication is used to decrease esophageal varices?

Demerol

Tidine

Propranolol (correct)

Prazole

Why should patients with GERD avoid lying down after eating?

To improve digestion

To reduce symptoms of GERD (correct)

To prevent atelectasis

To promote early ambulation

What is a common complication of cirrhosis?

Ascites Signup and view all the answers

What is the purpose of fundoplication?

To prevent acid back-up and hiatal hernia Signup and view all the answers

What is the purpose of a T-tube in a cholecystectomy?

To drain the common bile duct Signup and view all the answers

What is the recommended time to take medications for maximum effectiveness?

Late at night Signup and view all the answers

What is a sign of Encephalopathy in patients with cirrhosis?

Flapping of hands when arms are extended Signup and view all the answers

What is a common side effect of cytoprotective drugs?

Constipation Signup and view all the answers

What is the purpose of giving Lasix to patients with cirrhosis?

To decrease abdominal swelling Signup and view all the answers

What is a sign of inadequate blood supply to the stoma?

Bluish color Signup and view all the answers

What is the recommended position for patients after a liver biopsy?

Right side lying position Signup and view all the answers

What is the recommended timing for fluids in relation to eating to prevent dumping syndrome?

Avoid fluids 1 hour before and 2 hours after eating Signup and view all the answers

What is the normal progression of the stoma over time?

It shrinks over weeks Signup and view all the answers

What is the primary concern when a patient is vomiting blood?

Protecting the patient's airway Signup and view all the answers

A patient with a suspected perforation is likely to have a hard, rigid abdomen due to:

Peritonitis Signup and view all the answers

A patient with appendicitis may have a positive:

All of the above Signup and view all the answers

What is the primary goal of postoperative care for a patient with a gallstone?

All of the above Signup and view all the answers

What is the characteristic of the stool in a patient with an ileostomy?

Watery Signup and view all the answers

How often should the stoma of a patient with an ileostomy or colostomy be checked?

Every 8 hours Signup and view all the answers

What is the characteristic of a healthy stoma?

Pink and moist Signup and view all the answers

What type of ostomy is associated with a liquidy stool?

Ascending ostomy Signup and view all the answers

What is the recommended meal plan for patients with gastrointestinal issues?

Eat small frequent meals Signup and view all the answers

What is the primary cause of Chronic Type B gastrointestinal issues?

H pylori infection Signup and view all the answers

What is the treatment for Peptic Ulcer Disease (PUD)?

PPI plus 2 antibiotics Signup and view all the answers

What is the purpose of antacids in treating gastrointestinal issues?

Neutralize stomach acid Signup and view all the answers

What is a common complication of Peptic Ulcer Disease (PUD)?

Perforation Signup and view all the answers

When is the best time to take antacids?

1 hour before or after meals Signup and view all the answers

What is a contraindication for H2 blockers?

Theophylline Signup and view all the answers

What is the mechanism of action of PPIs?

Prevent final transportation of Hydrogen ions Signup and view all the answers

Study Notes

GERD (Gastroesophageal Reflux Disease)

Symptoms: dyspepsia (burning/heartburn), worsened pain while lying down, weight loss, regurgitation, dysphagia, bleeding, and loss of tooth enamel
Patient teaching: avoid bedtime snacks, eat small frequent meals, avoid caffeine, milk products, spicy foods, and citrus
Treatment: antacids, H2 blockers (e.g. tidine), and PPI (Prazole)
Lifestyle modifications: drink fluids between meals, avoid lying down after eating, and elevate the head of the bed (HOB) 4-6 inches

Cholecystectomy (Gallbladder Removal)

Surgical procedure: laparoscopy and T-tube placement in the common bile duct
Post-operative care: monitor drainage (yellowish-brown color), keep tube under the surgical site, and turn off suction to assess bowel sounds
Patient teaching: avoid atelectasis by taking deep breaths and coughing only when medicated, and encourage early ambulation
Complications: impaired gas exchange and fluid deficit

Cirrhosis

Symptoms: RUQ pain, fatigue, and ascites (fluid accumulation in the abdomen)
Patient teaching: limit activity, rest, and decrease fluid intake
Treatment: diuretics (e.g. Lasix) to reduce abdominal swelling, and paracentesis for ascites
Complications: encephalopathy ( Asterixis, confusion, and increased ammonia levels)

Liver Biopsy

Procedure: left side lying position during biopsy, and right side lying position post-operatively
Complications: bleeding and encephalopathy

Esophageal Varices

Treatment: vasoconstrictors (e.g. Propranolol) to decrease varices, and vitamin K for clotting
Patient care: protect airway, monitor vital signs, and maintain a side-lying position

GI Perforation

Assessment: hard, rigid board-like abdomen, abdominal pain radiating to the shoulder, restlessness, and apprehension
Treatment: avoid applying heat, and consider surgical intervention

Appendicitis

Symptoms: located in the RLQ, positive McBurney's point (pain in RLQ when touched), Rovsig's point (pain in LLQ when RLQ palpated), rebound tenderness, and radiating pain
Treatment: IV and antibiotic therapy, and surgical intervention
Complications: perforation and peritonitis

Gallstones

Symptoms: same as cholecystectomy
Treatment: laparoscopy and T-tube placement in the common bile duct
Patient teaching: same as cholecystectomy

Ileal Conduit/Colostomy

Procedure: removal of the colon, and creation of an ileostomy or colostomy
Stoma care: monitor for pink, moist, and healthy stoma, and check for discoloration and abnormalities every 8 hours
Diet: eat small, frequent meals, and avoid fatty foods, seeds, and broccoli
Complications: impaired gas exchange and fluid deficit

Gastroenteritis

Definition: inflammation of the GI tract
Types: autoimmune (Chronic Type A) and PUD (Chronic Type B)
Symptoms: heartburn, belching, sour taste, nausea, and vomiting
Treatment: PPI and 2 antibiotics

Peptic Ulcer Disease (PUD)

Symptoms: gut pain 1-2 hours after meals, radiating to the shoulder area, and weight loss
Treatment: PPI and 2 antibiotics
Complications: perforation, hard, rigid abdomen, and bleeding

Medication Classification and Patient Teaching

Antacids: neutralize stomach acid, take 1 hour before or after meals, and not with other medications
H2 blockers (e.g. tidine): decrease acid production, take 30 minutes before meals, and can cause confusion
PPI (e.g. Prazole): prevents final transportation of hydrogen ions, take in the morning, and can cause bone breakdown
Cytoprotective drugs (e.g. pepto-bismol, sucralfate): used as a bandaid, take on an empty stomach, and can cause constipation and abdominal discomfort

Ostomy Assessments

Vital signs: monitor for pink, moist, and healthy stoma
Skin around the stomach: monitor for irritation
Stoma shrinks over time, which is normal

Dumping Syndrome

Definition: rapid entry of food into the jejunum
Symptoms: dizziness, increased heart rate, sweating, nausea, abdominal cramps, and diarrhea
Treatment: avoid fluids 1 hour before and 2 hours after eating

Fundoplication

Procedure: wraps the upper part of the stomach around the esophagus to form a collar-like structure
Goal: prevent acid back-up and air hiatal hernia
Post-operative care: elevate the head of the bed (HOB) 6-10 days, and monitor for dysphagia

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Description

This quiz covers the symptoms and treatment of Gastroesophageal Reflux Disease (GERD), including dyspepsia, regurgitation, and weight loss. It also discusses patient teaching strategies, such as dietary changes and medication management.