Chapter 54, Care of Patients with Esophageal Problems

What are common complications associated with gastroesophageal reflux disease (GERD) in the older adult? Select all that apply.

-Sleep apnea -Barrett's esophagus -Esophageal strictures -Aspiration pneumonia

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

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?

-Changing to decaffeinated coffee

A patient with a hiatal hernia is prescribed famotidine. What is the action of this drug in the treatment of hiatal hernia?

-Decreases gastric acid secretions

The nurse is assessing a patient with gastroesophageal reflux disease (GERD). Which findings does the nurse expect to observe? Select all that apply.

-Dyspepsia -Regurgitation -Flatulence -Excessive salivation

Which measure is useful in preventing esophageal reflux?

-Eating four to six small meals every day

Which nursing intervention is beneficial for a patient with a hiatal hernia?

-Elevating the head of the bed to 6 inches at night

What symptom should be assessed for in a patient suspected of having gastroesophageal reflux disease (GERD)?

-Eructation

Which symptoms should be assessed for in a patient suspected of having gastroesophageal reflux disease (GERD)? Select all that apply.

-Eructation -Flatulence

Esomeprazole is prescribed to a patient with gastroesophageal reflux disease (GERD). What adverse effect might this medication cause?

-Gastrointestinal (GI) infection

Which initial treatment is typically recommended for a patient diagnosed with a sliding hiatal hernia?

-Nonpharmacologic treatment such as positioning for sleep and eating

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?

-Odynophagia

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?

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

A patient diagnosed with gastroesophageal reflux disease (GERD) reports a sensation of fluid in the throat that does not have the bitter taste previously experienced with reflux. What symptom is this patient experiencing?

-Water brash

A patient has been diagnosed with mild gastroesophageal reflux disease (GERD) and asks the nurse about nonpharmacologic treatments to prevent symptoms. What does the nurse tell this patient?

-"Avoid caffeine-containing foods and beverages."

The nurse is preparing a health promotion and lifestyle changes chart for a patient with gastroesophageal reflux disease (GERD). Which teaching will the nurse include?

-"Avoid sleeping flat in the bed."

The nurse is teaching a patient with a hiatal hernia about how to prevent heartburn. What statement by the patient indicates a need for further teaching?

-"I should lie down in the flat position following meals."

A patient diagnosed with gastroesophageal reflux disease (GERD) reports heartburn. Which drug classifications may cause heartburn? Select all that apply.

-Calcium channel blockers -Anticholinergic drugs -Oral contraceptives -Nitrates

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?

-Changing to a twice-daily dosing regimen

The nurse is caring for a patient with gastroesophageal reflux disease (GERD) who presents with retrosternal burning. What term does the nurse use to document this symptom?

-Pyrosis

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?

-"Ranitidine does not prevent actual reflux."

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?

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

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?

-"One goal of drug therapy is to prevent severe complications."

A patient with gastroesophageal reflux disease (GERD) has undergone a laparoscopic Nissen fundoplication (LNF). What will the nurse include in postoperative home care instructions?

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

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?

-"Small dressings can be removed after 10 days."

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?

-Altering dietary and eating habits

What risk factors are associated with the development of gastroesophageal reflux disease (GERD)? Select all that apply.

-Ascites -Obesity -Pregnancy -Wearing tight girdles

Which dietary modifications will be important for a patient newly diagnosed with gastroesophageal reflux disease (GERD)? Select all that apply.

-Avoidance of chocolate -Avoidance of tomatoes and tomato-based foods -Avoidance of coffee and other caffeinated beverages

Which complications of gastroesophageal reflux disease (GERD) are more commonly seen in older adults? Select all that apply.

-Barrett's esophagus -Esophageal erosions -Aspiration pneumonia

What symptoms are suggestive of a sliding hiatal hernia? Select all that apply.

-Belching -Heartburn -Difficulty in swallowing -Backward flow of food into throat

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?

-Obstructive sleep apnea (OSA)

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