Questions and Answers
What are some manifestations of GERD? (Select all that apply)
What is Gastroesophageal Reflux Disease (GERD)?
Backward flow of stomach contents into the esophagus resulting in inflammatory changes.
Patients with prolonged GERD are at increased risk of cancer.
True
What is the most accurate diagnostic test for GERD?
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Which of the following are recommended nursing interventions for GERD? (Select all that apply)
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Dysphagia refers to difficulty in _____
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What is Barrett's epithelium?
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What lifestyle change can help minimize nighttime episodes of reflux?
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Study Notes
Gastroesophageal Reflux Disease (GERD)
- Characterized by backward flow of stomach contents into the esophagus, leading to inflammatory changes in the esophageal mucosa.
- Hallmark symptom: reflux esophagitis, indicating acute inflammation.
- Considered pre-malignant with increased risk of cancer in patients with prolonged GERD.
Symptoms of GERD
- Chronic cough, particularly at night, often due to sleeping position.
- Asthma-like symptoms may arise.
- Gastrointestinal complaints include:
- Eructation (belching)
- Flatulence (gas)
- Bloating after meals
- Nausea and vomiting
Diagnostic Tests
- 24-hour ambulatory pH monitoring is the most accurate method to assess esophageal acidity.
- Endoscopy (esophagogastroduodenoscopy) for direct visualization of the esophagus and gastric mucosa.
- Esophageal manometry (motility testing) measures lower esophageal sphincter (LES) pressure and peristalsis, but is not specific for GERD diagnosis.
Causes of GERD
- Inappropriate relaxation or decreased tone of the LES.
- Elevated gastric volume or intra-abdominal pressure.
- Delayed gastric emptying can also exacerbate symptoms.
Nursing Interventions for GERD
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Dietary Modifications:
- Avoid foods that lower LES pressure such as chocolate, fatty foods, and caffeinated beverages (coffee, tea, cola).
- Restrict spicy and acidic foods like orange juice and tomatoes.
- Limit carbonated beverages due to increased stomach pressure.
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Lifestyle Changes:
- Encourage sleeping in a left lateral position to reduce nighttime reflux episodes.
Assessment Findings for GERD
- Heartburn: described as substernal or retro-sternal burning sensation, potentially radiating to neck, jaw, or back (mimics angina or myocardial infarction).
- Regurgitation: sensation of warm fluid in the throat, with a sour or bitter taste, poses aspiration risk (check for lung crackles).
- Hypersalivation ("water brash") may occur.
- Dysphagia: difficulty swallowing, may progress to odynophagia (painful swallowing).
- Barrett’s epithelium: abnormal change from squamous epithelial cells to columnar cells, indicates severe GERD.
Gastritis
- Acute gastritis is characterized by a short duration but can lead to extensive damage if the gastric mucosa is severely compromised.
- Foods with rough textures or extremely high temperatures can further damage the stomach lining.
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Description
This quiz covers essential topics from the Gastrointestinal Disorders section of the NCM112 course, focusing on conditions like GERD, Gastritis, PUD, and Dumping Syndrome. Ideal for nursing students preparing for their preliminary assessments, the quiz evaluates understanding of the pathophysiology and management of these disorders.
