Gerd

Asthma

A patient presents with signs and symptoms of gastroesophageal reflux disease (GERD). What common misdiagnosis should the nurse look for in the patient's recent history? Asthma Crohn's disease Sick sinus syndrome Uncontrolled hypertension

'Remain on a soft diet for about a week and avoid raw fruits and vegetables.'

A patient with gastroesophageal reflux disease (GERD) has undergone a laparoscopic Nissen fundoplication (LNF). What will the nurse include in postoperative home care instructions? a. 'You may resume running and weight lifting if you wish. b. ''You may stop taking your anti-reflux medications after 1 week. c. ''Consume carbonated beverages if you experience stomach upset. d. ''Remain on a soft diet for about a week and avoid raw fruits and vegetables.'

'Remain on a soft diet for about a week and avoid raw fruits and vegetables.' After LNF, patients should be taught to remain on a soft diet for one week. Carbonated beverages should be avoided. Patients may walk but should avoid heavy lifting. Anti-reflux medications should be taken for 1 month after the procedure.

A patient with gastroesophageal reflux disease (GERD) has undergone a laparoscopic Nissen fundoplication (LNF). What will the nurse include in postoperative home care instructions? a. You may resume running and weight lifting if you wish. b. ''You may stop taking your anti-reflux medications after 1 week. c. ''Consume carbonated beverages if you experience stomach upset. d. ''Remain on a soft diet for about a week and avoid raw fruits and vegetables.'

Auscultate the patient's lung sounds....

A patient with gastroesophageal reflux disease (GERD) reports a frequent sour taste in the back of the throat. What is a priority nursing action for this patient? Palpate the patient's abdomen Evaluate the patient's dietary habits Auscultate the patient's lung sounds Monitor the patient's ability to swallow

Report this symptom to the provider so the cause can be determined

A patient with gastroesophageal reflux disease (GERD) reports onset of midsternal chest pain radiating to the left arm. What is the correct priority action by the nurse? a. Reassure the patient that this is a common symptom of GERD b. Report this symptom to the provider so the cause can be determined c. Administer pain medications if ordered and continue to evaluate pain d. Elevate the head of the patient's bed to 30 degrees to minimize reflux.

Sliding hernia

A portion of a patient's fundus and the esophagogastric junction has moved upward and through the esophageal hiatus. Which condition does this describe? Sliding hernia Esophageal reflux Esophageal diverticula Paraesophageal hernia

Smoking, peppermint, and aged cheese Smoking, peppermint, and aged cheese that includes nitrates are all risk factors for contributing to decreased lower esophageal sphincter pressure. Legumes and artificially sweetened beverages do not affect the lower esophageal sphincter.

Which risk factors should be included when teaching about reducing the risk of proton pump inhibitors (PPIs) for a patient at risk for development of gastroesophageal reflux disease (GERD)? Select all that apply. Smoking Legumes Peppermint Aged cheeses Artificially sweetened beverages

Elevate the head of the bed to a 30-degree angle

A hospitalized patient who is obese is at risk for aspiration a. Teach the patient to avoid alcohol and smoking b. Educate the patient about weight loss strategies c. Elevate the head of the bed to a 30-degree angle d. Perform a dietary history to identify problem foods

Elevate the head of the bed to a 30-degree angle...

A hospitalized patient who is obese is at risk for aspiration pneumonia. What is the priority action by the nurse? a. Teach the patient to avoid alcohol and smoking b. Educate the patient about weight loss strategies c. Elevate the head of the bed to a 30-degree angle d. Perform a dietary history to identify problem food

nitrates, oral contraceptives, anticholinergic drugs, and calcium channel blockers.

A patient diagnosed with gastroesophageal reflux disease (GERD) reports heartburn. Which drug classifications may cause heartburn? Nitrates Prokinetic drugs Oral contraceptives Anticholinergic drugs Proton pump inhibitors Calcium channel blockers

Nitrates Oral contraceptives Anticholinergic drugs Calcium channel blockers several drugs decrease lower esophageal sphincter (LES) pressure causing reflux of gastric content and heartburn in GERD. These include nitrates, oral contraceptives, anticholinergic drugs, and calcium channel blockers. Prokinetic drugs and proton pump inhibitors do not cause heartburn; they are used in the treatment of GERD

A patient diagnosed with gastroesophageal reflux disease (GERD) reports heartburn. Which drug classifications may cause heartburn? Select all that apply. a. Nitrates b. Prokinetic drugs c. Oral contraceptives d. Anticholinergic drugs e. Proton pump inhibitors f. Calcium channel blockers

pH Prolonged use of antacids may elevate the pH level of the gastric contents; therefore they should be used short-term. Antacids do not affect the patient's platelet count, ammonia level, or WBC count.

A patient diagnosed with gastroesophageal reflux disease (GERD) reports taking antacids multiple times a day for the last couple of months. What lab value should be assessed in this patient? pH Platelet count Ammonia level White blood cell (WBC) count

Asks the patient about medications and dietary intake

A patient in the outpatient clinic tells the nurse about experiencing heartburn and nighttime coughing episodes. Which action does the nurse take first? a. Asks the patient about medications and dietary intake b. Teaches the patient about antacid effects and side effects c. Tells the patient to avoid drinking alcohol late in the evening d. Suggests that the patient sleep with the head elevated 6 inches

a. Asks the patient about medications and dietary intake

A patient in the outpatient clinic tells the nurse about experiencing heartburn and nighttime coughing episodes. Which action does the nurse take first? a. Asks the patient about medications and dietary intake b. Teaches the patient about antacid effects and side effects c. Tells the patient to avoid drinking alcohol late in the evening d. Suggests that the patient sleep with the head elevated 6 inches

'The pH is monitored when I press the button on the monitoring device.'

A patient is scheduled to have ambulatory pH monitoring for diagnosis of gastroesophageal reflux disease (GERD). Which statement by the patient indicates a need for further teaching? a. They will put a catheter through my nose into my esophagus. b. ''I will have a little capsule attached to the wall of my esophagus. c. ''The pH is monitored when I press the button on the monitoring device.' d.'I will have to keep a diary of my activities and symptoms for 24 to 48 hours.'

Keep a record of all symptoms and activities during the test

A patient is scheduled to undergo 24-hour ambulatory esophageal pH monitoring. When teaching this patient about the procedure, what does the nurse instruct the patient to do? a. Take antacids to minimize acid reflux discomfort b. Consume a clear liquid diet while the probe is in place. c. Keep a record of all symptoms and activities during the test d.Avoid driving because sedation is required during the procedure

Keep a record of all symptoms and activities during the test.....

A patient is scheduled to undergo 24-hour ambulatory esophageal pH monitoring. When teaching this patient about the procedure, what does the nurse instruct the patient to do? a. Take antacids to minimize acid reflux discomfort b. Consume a clear liquid diet while the probe is in place c. Keep a record of all symptoms and activities during the test c. Avoid driving because sedation is required during the procedure

''One goal of drug therapy is to prevent severe complications.'

A patient newly diagnosed with gastroesophageal reflux disease (GERD) asks the nurse what the prescribed medications are intended to do. What does the nurse tell the patient? a. 'Medications for GERD will eventually cure the disease. b. ''Antacid medications will prevent worsening of the reflux. c. ''One goal of drug therapy is to prevent severe complications.' d. 'GERD medications relieve symptoms but do not treat esophagitis.'

One goal of drug therapy is to prevent severe complications.'

A patient newly diagnosed with gastroesophageal reflux disease (GERD) asks the nurse what the prescribed medications are intended to do. What does the nurse tell the patient? a. Medications for GERD will eventually cure the disease. b. ''Antacid medications will prevent worsening of the reflux.' c. 'One goal of drug therapy is to prevent severe complications.' d. 'GERD medications relieve symptoms but do not treat esophagitis.'

Reassure the patient that this is a temporary problem after this type of surgery..

A patient who had open Nissen fundoplication 2 days ago has been instructed to begin oral fluids but reports dysphagia associated with fluid intake. Which action by the nurse is correct?

Reassure the patient that this is a temporary problem after this type of surgery

A patient who had open Nissen fundoplication 2 days ago has been instructed to begin oral fluids but reports dysphagia associated with fluid intake. Which action by the nurse is correct? a. Notify the surgeon about this potentially serious complication b. Contact the provider to request a laxative to promote peristalsis c. Reassure the patient that this is a temporary problem after this type of surgery d. Tell the patient that this means the fundoplication is too tight and will require dilation

'Report nausea, vomiting, or shortness of breath immediately.'

A patient who has undergone a Stretta procedure is about to be discharged. What does the nurse teach this patient about postprocedure care? a. 'Consume a soft diet for the first 24 hours after the procedure.' b. 'Discontinue taking prescribed proton pump inhibitors (PPIs).' c. 'Report nausea, vomiting, or shortness of breath immediately.' d. 'Use a nonsteroidal anti-inflammatory drug (NSAID) for postprocedure pain.'

The need to contact the provider at the first sign of a respiratory infection

A patient who has undergone a conventional fundoplication is preparing to be discharged home. To minimize the risk that the fundoplication will dehisce, what does the nurse include when teaching this patient about home management? a. The need to belch frequently to eliminate air from the stomach b. How to correctly insert a nasogastric tube to minimize bloating c. The need to contact the provider at the first sign of a respiratory infection d. The importance of eating three well-balanced meals daily to facilitate healing

c. The need to contact the provider at the first sign of a respiratory infection

A patient who has undergone a conventional fundoplication is preparing to be discharged home. To minimize the risk that the fundoplication will dehisce, what does the nurse include when teaching this patient about home management? a. The need to belch frequently to eliminate air from the stomach. b. How to correctly insert a nasogastric tube to minimize bloating c. The need to contact the provider at the first sign of a respiratory infection d. The importance of eating three well-balanced meals daily to facilitate healing

'Ranitidine does not prevent actual reflux.' The drugs used to treat GERD act by reducing or preventing gastric acid secretion, thus improving symptoms, but they do not affect reflux itself..

A patient who will begin taking ranitidine to treat gastroesophageal reflux disease (GERD) asks the nurse if the medication will cure the disease. Which answer by the nurse is correct? a. 'Ranitidine does not prevent actual reflux. b. ''You will notice increased effects over time. c. ''An increased dose may be necessary to cure GERD. d. ''Your provider may order a proton pump inhibitor instead.'

Odynophagia - Odynophagia (painful swallowing) manifests as pain that may persist for several hours after swallowing as a result of spasms in the esophagus. Dysphagia refers to difficulty swallowing not associated with pain. Eructation is belching. Regurgitation is reflux of stomach contents into the esophagus.

A patient with gastroesophageal reflux disease (GERD) has severe chest pain lasting for several hours after eating. Which common symptom of GERD is the patient experiencing? Eructation Dysphagia Odynophagia Regurgitation

Report this symptom to the provider so the cause can be determined

A patient with gastroesophageal reflux disease (GERD) reports onset of midsternal chest pain radiating to the left arm. What is the correct priority action by the nurse? a. Reassure the patient that this is a common symptom of GERD b. Report this symptom to the provider so the cause can be determined c. Administer pain medications if ordered and continue to evaluate pain d. Elevate the head of the patient's bed to 30 degrees to minimize reflux

Report this symptom to the provider so the cause can be determined..

A patient with gastroesophageal reflux disease (GERD) reports onset of midsternal chest pain radiating to the left arm. What is the correct priority action by the nurse? a. Reassure the patient that this is a common symptom of GERD b. Report this symptom to the provider so the cause can be determined c. Administer pain medications if ordered and continue to evaluate pain d. Elevate the head of the patient's bed to 30 degrees to minimize reflux

Avoiding eating 3 hours prior to bedtime

A patient with gastroesophageal reflux disease (GERD) undergoes esophagoscopy that reveals increased esophageal erosion. Which is the priority intervention that the nurse teaches this patient? a. Avoiding eating 3 hours prior to bedtime b. Sitting upright for 30 minutes after eating c. Eating slowly and chewing foods thoroughly d. Restricting caffeine and chocolate in the diet

Avoiding eating 3 hours prior to bedtime..

A patient with gastroesophageal reflux disease (GERD) undergoes esophagoscopy that reveals increased esophageal erosion. Which is the priority intervention that the nurse teaches this patient? a. Avoiding eating 3 hours prior to bedtime b. Sitting upright for 30 minutes after eating c. Eating slowly and chewing foods thoroughly d. Restricting caffeine and chocolate in the diet

Indigestion Hoarseness Painful swallowing Indigestion, hoarseness, and painful swallowing are the symptoms of gastroesophageal reflux disease (GERD), which occurs frequently with OSA. Breathlessness after eating and feeling full after eating are symptoms of hiatal hernia, which is not associated with OSA.

After assessing a patient, the nurse suspects the diagnosis will be obstructive sleep apnea (OSA). Which other symptoms in addition to excessive daytime sleepiness should the nurse look for in the patient? a. Indigestion b. Hoarseness c. Painful swallowing d. Breathlessness after eating f. Feeling of fullness after eating

a.Indigestion b. Hoarseness c. Painful swallowing Indigestion, hoarseness, and painful swallowing are the symptoms of gastroesophageal reflux disease (GERD), which occurs frequently with OSA. Breathlessness after eating and feeling full after eating are symptoms of hiatal hernia, which is not associated with OSA.

After assessing a patient, the nurse suspects the diagnosis will be obstructive sleep apnea (OSA). Which other symptoms in addition to excessive daytime sleepiness should the nurse look for in the patient? Select all that apply. a.Indigestion b. Hoarseness c. Painful swallowing d. Breathlessness after eating e. Feeling of fullness after eating

Obstructive sleep apnea (OSA) A patient with frequent indigestion, nausea, and heartburn is showing symptoms indicative of gastroesophageal reflux disease (GERD)

The nurse is assessing a patient who reports nausea, indigestion, and heartburn. Upon reviewing the patient's lab results, the nurse observes the patient's electrolyte levels are normal. Which condition does the nurse most expect the patient to have? Anorexia Depression Hypothyroidism Obstructive sleep apnea (OSA)

Obstructive sleep apnea (OSA)

The nurse is assessing a patient who reports nausea, indigestion, and heartburn. Upon reviewing the patient's lab results, the nurse observes the patient's electrolyte levels are normal. Which condition does the nurse most expect the patient to have? Anorexia Depression Hypothyroidism Obstructive sleep apnea (OSA)

a. Dyspepsia b. Flatulence c. Regurgitation d. Excessive salivation

The nurse is assessing a patient with gastroesophageal reflux disease (GERD). Which findings does the nurse expect to observe? Select all that apply. a. Dyspepsia b. Flatulence c. Regurgitation d. Excessive salivation e. Blood-tinged sputum

Dyspepsia Flatulence Regurgitation Excessive salivation

The nurse is assessing a patient with gastroesophageal reflux disease (GERD). Which findings does the nurse expect to observe? Select all that apply. Dyspepsia Flatulence Regurgitation Excessive salivation Blood-tinged sputum

Difficulty belching Abdominal distension Difficulty swallowing Temperature of 101° F.

The nurse is caring for a patient who just underwent a laparoscopic Nissen fundoplication procedure. Which symptoms, if demonstrated by the patient, would indicate to the nurse that complications are developing? Select all that apply. Sore throat Difficulty belching Abdominal distension Difficulty swallowing Soft stools after 6 days Temperature of 101° F

Using a pillow to support the incision when the patient coughs...

The nurse is caring for a patient with a hiatal hernia who had an open fundoplication yesterday. Which task does the nurse delegate to unlicensed assistive personnel (UAP)? a. Adjusting the position of the nasogastric (NG) tube b. Giving the patient sips of water once bowel sounds are heard c. Assessing the level of postoperative pain using a 0 to 10 scale d. Using a pillow to support the incision when the patient coughs

Altering dietary and eating habits Initial treatment for mild GERD involves nutrition therapy including changes in types of foods and changes in eating patterns. Lifestyle changes such as weight loss and sleeping habits are approached next. Medication therapy is used for more severe symptoms or for those who do not improve with dietary and lifestyle changes.

The nurse is counseling a patient who has been diagnosed with mild gastroesophageal reflux disease (GERD). What does the nurse teach the patient initially about managing this condition? a. Changing sleeping positions b. Using proton pump inhibitors c. Taking over-the-counter antacids d. Altering dietary and eating habits

Altering dietary and eating habits

The nurse is counseling a patient who has been diagnosed with mild gastroesophageal reflux disease (GERD). What does the nurse teach the patient initially about managing this condition? a. Changing sleeping positions b. Using proton pump inhibitors c. Taking over-the-counter antacids d. Altering dietary and eating habits

Tomato products and tomatoes...

The nurse is performing a dietary history on a patient who was admitted for evaluation of atypical chest pain lasting up to 2 hours that occurs after meals. Which foods does the nurse ask the patient about? High-protein foods Beans and legumesFoods containing gluten Tomato products and tomatoes

Changing to a twice-daily dosing regimen

The nurse is reviewing the medication history for a patient diagnosed with gastroesophageal reflux disease (GERD) who has been prescribed esomeprazole once daily. The patient reports that the drug doesn't completely control the symptoms. The nurse contacts the provider to discuss which intervention? a. Switching to omeprazole b. Increasing the dose of esomeprazole c. Changing to a twice-daily dosing regimen d. Adding a second proton-pump inhibitor medication

Changing to a twice-daily dosing regimen

The nurse is reviewing the medication history for a patient diagnosed with gastroesophageal reflux disease (GERD) who has been prescribed esomeprazole once daily. The patient reports that the drug doesn't completely control the symptoms. The nurse contacts the provider to discuss which intervention? a. Switching to omeprazole b. Increasing the dose of esomeprazole c. Changing to a twice-daily dosing regimen d. Adding a second proton-pump inhibitor medication

''Small dressings can be removed after 10 days.

The nurse is teaching a group of nursing students about the postoperative interventions needed following laparoscopic Nissen fundoplication (LNF). Which statement by a nursing student indicates a need for further instruction? a. A soft diet should be maintained for 1 week. b. ''Driving is prohibited for 1 week after surgery. c. ''Small dressings can be removed after 10 days. d. ''Anti-reflux medication should be administered for 1 month....

'If you develop diarrhea, you may need to try an aluminum salt antacid.'

The nurse is teaching a patient about taking an antacid containing magnesium salts to treat heartburn associated with gastroesophageal reflux disease (GERD). What does the nurse include in the teaching? a. 'You may develop severe constipation while taking this medication. b. ''This medication will help resolve the reflux associated with GERD. c.''If you develop diarrhea, you may need to try an aluminum salt antacid.' d. 'Take this medication with food or just before eating to improve absorption.'

Avoid working in a bent-over position

The nurse prepares a teaching session regarding lifestyle changes needed to decrease the discomfort associated with a patient's hiatal hernia. Which change does the nurse recommend to this patient? Drink tea instead of coffee Eat only two or three meals daily Sleep flat in a left side-lying position Avoid working in a bent-over position

Sleep apnea Barrett's esophagus Esophageal strictures In older adults with GERD the incidence of heartburn decreases and instead they develop more severe complications such as sleep apnea, Barrett's esophagus, esophageal strictures, and aspiration pneumonia. Esophageal diverticula can occur due to herniation of the esophageal mucosa and submucosa into the surrounding tissue. Esophageal perforation may occur when excessive force is exerted on the esophageal mucosa.

What are common complications associated with gastroesophageal reflux disease (GERD) in the older adult? Select all that apply. a. Sleep apnea b. Barrett's esophagus c. Esophageal strictures d. Aspiration pneumonia e.Esophageal diverticula f.Esophageal perforation

Large meals Eating large meals causes gastric distention, which can lead to GERD. Belching, flatulence, and water brash do not lead to gastric distention.

What is a common cause of gastric distention that predisposes a patient to gastroesophageal reflux disease (GERD)? a. Belching b. Flatulence c. Water brash d. Large meals

d. Large meals Eating large meals causes gastric distention, which can lead to GERD. Belching, flatulence, and water brash do not lead to gastric distention.

What is a common cause of gastric distention that predisposes a patient to gastroesophageal reflux disease (GERD)? a. Belching b. Flatulence c. Water brash d. Large meals

a. Limit caffeine. b. Decrease chocolate intake.

What nutritional information should be included in the teaching plan for a patient diagnosed with gastroesophageal reflux disease (GERD)? Select all that apply. a. Limit caffeine b. Eat a peppermint c. Decrease chocolate intake d. Eat three small meals a day e. Avoid drinking fluids at meals

Belching Heartburn Difficulty in swallowing The symptoms of a sliding hiatal hernia are belching (eructation), heartburn, difficulty in swallowing (dysphagia), and the backward flow of food into the throat (regurgitation). A feeling of fullness after eating and worsening of symptoms when lying down are observed with a paraesophageal hiatal hernia.

What symptoms are suggestive of a sliding hiatal hernia? Select all that apply. a. Belching b. Heartburn c. Difficulty in swallowing d. Feeling of fullness after eating e. Backward flow of food into the throat f. Worsening of symptoms when lying down

Barrett's esophagus Esophageal erosions Aspiration pneumonia

Which complications of gastroesophageal reflux disease (GERD) are Which complications of gastroesophageal reflux disease (GERD) are more commonly seen in older adults? Select all that apply. Dementia Hiatal hernias Barrett's esophagus Esophageal erosions Aspiration pneumonia

Barrett's esophagus Esophageal erosions Aspiration pneumonia Barrett's esophagus, esophageal erosion, and aspiration pneumonia are commoncomplications seen in older adult patients with GERD. GERD does not increase the prevalence of dementia. Older adults with hiatal hernias are more prone to GERD; hiatal hernia is not a complication of GERD.

Which complications of gastroesophageal reflux disease (GERD) are more commonly seen in older adults? Select all that apply. Dementia Hiatal hernias Barrett's esophagus Esophageal erosions Aspiration pneumonia.

Nonpharmacologic treatment such as positioning for sleep and eating..

Which initial treatment is typically recommended for a. patient diagnosed with a sliding hiatal hernia? a. Swallowing therapy to help minimize reflux and discomfort b. Antacid therapy in conjunction with a histamine receptor antagonist c. Nonpharmacologic treatment such as positioning for sleep and eating d. Surgical intervention to prevent protrusion of the stomach into the thorax

Remain upright for one to two hours after meals

Which lifestyle modification will the nurse teach the patient with gastrointestinal reflux disease (GERD)? a. Sleep flat in bed b. Consume three meals a day c. Eat at least one hour before going to bed d. Remain upright for one to two hours after meals

Nitrates Oral contraceptives Nonsteroidal anti-inflammatory drugs (NSAIDs)

Which medications should the nurse ask if a patient is taking if the patient has a new diagnosis of gastroesophageal reflux disease (GERD)? Select all that apply. Nitrates Salicylates Beta blockers Oral contraceptives Nonsteroidal anti-inflammatory drugs (NSAIDs)

a. Nitrates c. Oral contraceptives e. Nonsteroidal anti-inflammatory drugs (NSAIDs) Nitrates, oral contraceptives, and NSAIDs can lead to lower esophageal sprinter pressure and cause reflux; therefore the nurse should ask the patient about taking any of these medications.

Which medications should the nurse ask if a patient is taking if the patient has a new diagnosis of gastroesophageal reflux disease (GERD)? Select all that apply. a.Nitrates b.Salicylates c. Beta blockers d. Oral contraceptives e. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Changing to decaffeinated coffee

Which recommendation would the nurse make first to a patient with gastroesophageal reflux disease (GERD) who is overweight and consuming several cups of caffeinated coffee and two soft drinks daily? a. Beginning a weight loss program b. Changing to decaffeinated coffee c. Eat two meals each day d. Drink caffeine-free carbonated drinks

Smoking, peppermint, and aged cheese all risk factors for contributing to decreased lower esophageal sphincter pressure

Which risk factors should be included when teaching about reducing the risk of proton pump inhibitors (PPIs) for a patient at risk for development of gastroesophageal reflux disease (GERD)? Select all that apply. a. Smoking b. Legumes c. Peppermint d. Aged cheeses e. Artificially sweetened beverages

Breathlessness Because a paraesophageal hiatal hernia involves protrusion of the fundus and other parts of the stomach into the thorax, patients often report breathlessness after a meal. The lower esophageal sphincter remains in place, so regurgitation is often not present. Dysphagia and eructation are associated with sliding hiatal hernia.

Which symptoms alert the nurse that a patient may have a paraesophageal hiatal hernia? Dysphagia Eructation Regurgitation Breathlessness

'Ranitidine does not prevent actual reflux...

patient who will begin taking ranitidine to treat gastroesophageal reflux disease (GERD) asks the nurse if the medication will cure the. disease. Which answer by the nurse is correct? a. 'Ranitidine does not prevent actual reflux. b. ''You will notice increased effects over time. c. ''An increased dose may be necessary to cure GERD. d. ''Your provider may order a proton pump inhibitor instead....