HAVE YOU EVER…
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HAVE YOU EVER…
GERD & GASTROENTERITIS
Harlene CastilloChristine ValdezClaudia Vasquez
November 17, 2010NURS 120
DEFINITION GERD occurs after
eating a meal Acidic contents refluxes
or moves upwards towards the esophagus
GASTROENTERITIS is when the stomach and both small and large intestines are inflamed.
ETIOLOGY GERD usually due to
having a weak lower esophageal sphincter.
GASTROENTERITIS Infection from different
viruses Sometimes AKA
“stomach flu” Nausea & vomiting
NOT similar to Gastritis
PATHOPHYSIOLOGY for GERD Lower Esophageal
Sphincter- doesn’t close
Backflow of gastric or duodenal contents (or both) no belching or vomiting
High acidity of the stomach causes irritation
Heartburn occurs (hormonal fluctuations, mechanical stress, effects of foods and drugs)
PATHOPHYSIOLOGY for GASTROENTERITIS Infected Food Ingested
These agents cause diarrhea by adherence, mucosal invasion, enterotoxin production, and/or cytotoxin production
Increased fluid secretion and/or decreased absorption.
increased luminal fluid content that cannot be adequately reabsorbed, leading to dehydration and the loss of electrolytes and nutrients.
Small intestines are primarily affected
GORDON’s Functional PatternsGERD Nutritional Metabolic
Patterns Imbalanced nutrition Impaired swallowing
GASTROENTERITIS Nutritional Metabolic
Pattern Nausea & vomiting
Elimination Pattern Diarrhea
Nursing ProcessASSESSMENT Determines client’s chief complaint Monitor for s/s (GERD) -dyspepsia, especially after eating -chronic cough -hypersalivation -flatulence (GASTROENTERITIS)
-Vomitting -Diarrhea -Abdominal discomfort, fever, headache -Dehydration Diet Lifestyle…..Smoke? Drink? Medications Sleep pattern Severity of pain and frequency
DIAGNOSIS Acute Pain
Deficit Knowledge
Disturbed Sleep Pattern
Fluid Electrolyte Imbalance
Nutrition Imbalance
PLANNING Plan of care that are measurable and
realistic
Ex: One to two episodes of heartburn per week,6 weeks after start of Protonix
Ex: Client’s electrolyte level within normal range before discharge
INTERVENTIONS Blood samples, stool specimens Diagnostic Tests (GERD)- Barium Upper GI - Endoscopy - Esophageal manometry Medications- Proton-pump inhibitors - Histamine2 receptor antagonists - Antacids - Anti-emetic - Anti-diarrheals - Antibiotics - IV Hydration
Client teachings
PATIENT TEACHING for GERD PREVENT reflux occurring at night,
elevate head of bed AVOID:
Lying down right after eatingEating large mealsDrinking alcoholSmokingFatty foodsCaffeineChocolate
PATIENT TEACHING for GASTROENTERITIS Practice good hand hygiene ALWAYS hydrate with clear fluids for first
24 hours to replenish electrolyte imbalance After 24 hours of not vomiting, start BRAT
diet However, when the patient is unable to
take fluids PO, the physician can intravenously (IV) give fluid to hydrate the patient- ensure presence of IV access.
EVALUATION Minimized severity of pain Minimized frequency/duration No further episodes of LBM, vomitting Labs within normal limits Improved sleep patterns What the goal reached?