Gastroesphageal Reflux Disease GERD Nursing Care Plans Diagnosis and InterventionsGastroesophageal Reflux Disease GERD NCLEX Review and Nursing Care Plans Show
Gastroesophageal reflux disease GERD is a medical condition that involves the stomach acid’s tendency to flow back into the esophagus, the tube that connects the mouth and the stomach. Also known as acid reflux, GERD results to the irritation and possible damage to the esophageal lining. GERD can happen anytime from once a week up until several times a week. Mild GERD is usually treated with over-the-counter medications and dietary changes. However, moderate to severe GERD may require prescription medications or even surgical interventions. Signs and Symptoms of GERD
When GERD occurs at night, the patient may also experience chronic cough, laryngitis, disrupted sleep, or new or worsening asthma. Causes and Risk Factors of GERDThe lower esophageal sphincter is a band of muscle below the esophagus that, when relaxed, allows food to enter the stomach. This sphincter normally closed when the food and liquid have passed it. A weakened lower esophageal sphincter results to the regurgitation or the flowing back of the stomach acid but up to the esophagus. The continuous acid reflux may damage the esophageal lining and may eventually cause inflammation. People who are at a higher risk for GERD include those who have obesity, connective tissue disorders (e.g. scleroderma), hiatal hernia, delayed stomach emptying. Pregnancy may also contribute to the development of GERD. Some lifestyle related factors that may trigger an acid reflux include smoking, alcohol, coffee, fatty or fried foods, certain medications (e.g. aspirin), and eating late at night or eating large meals. Complications of GERD
Treatment of GERDMedications
Surgical Intervention. The lower esophageal sphincter can be tightened by the surgeon in a procedure called fundoplication. Another option is through the use of the LINX device, which is a ring composed of small magnetic beads that wrap the area between the stomach and esophagus, preventing reflux while allowing food to enter the stomach. Lifestyle changes. Obesity is one of the risk factors for GERD, so it is imperative to help the patient maintain a weight that is within his/her normal BMI range. Smoking cessation and reduced alcohol intake can help prevent acid reflux. Nursing Diagnosis for GERDGerd Nursing Care Plan 1Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements reduced food intake secondary to GERD, as evidenced by weight loss, nausea and vomiting, loss of appetite, dysphagia, heartburn, and muscle mass loss Desired Outcome: The patient will be able to achieve a weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.
Gerd Nursing Care Plan 2Nursing Diagnosis: Acute Pain related to acid reflux secondary to GERD, as evidenced by pain score of 10 out of 10, verbalization of chest pain after eating, guarding sign on the chest, blood pressure level of 180/90, respiratory rate of 29 cpm, and restlessness Desired Outcome: The patient will demonstrate relief of pain as evidenced by a pain score of 0 out of 10, stable vital signs, and absence of restlessness.
Gerd Nursing Care Plan 3Nursing Diagnosis: Impaired tissue integrity related to esophageal exposure to gastric acid.
Gerd Nursing Care Plan 4Nursing Diagnosis: Risk for aspiration related to esophageal disease affecting the lower esophageal sphincter.
Gerd Nursing Care Plan 5Anxiety Nursing Diagnosis: Anxiety related to a change in the health status of the infant secondary to severe Gastroesophageal Reflux Disease (GERD) as possibly evidenced by increased fear that the disease will worsen and that surgery will be required and expressed concern and worry about the upcoming surgery, pre and post-operative care, gastrostomy and therapies while in the hospital, and complications after surgery. Desired Outcome: The parent will report a reduction in anxiety level to none or mild.
Gerd Nursing Care Plan 6Nausea Nursing Diagnosis: Nausea related to irritation of gastric mucosa secondary to Gastroesophageal Reflux Disease (GERD) as possibly evidenced by gagging sensation, aversion toward food, and verbal report of nausea. Desired Outcomes:
Gerd Nursing Care Plan 7Deficient Knowledge Nursing Diagnosis:Deficient Knowledge related to the scarcity of information about the disease/ disease process, lack of information or recall, unfamiliarity with information resources, and information misinterpretation secondary to Gastroesophageal Reflux Disease (GERD) possibly evidenced by the presence of preventable complications, verbalization of problems, request for information, and inaccurate follow-through of instructions. Desired Outcomes:
Nursing ReferencesAckley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon Disclaimer:Please follow your facilities guidelines and policies and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. Which instructions should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?Discharge Instructions for Gastroesophageal Reflux Disease (GERD). Maintain a healthy weight. ... . Avoid lying down after meals.. Avoid eating late at night.. Elevate the head of your bed by 6 inches. ... . Avoid wearing tight-fitting clothes.. Avoid foods that might irritate your stomach, such as the following:. What patient teaching would be given to the patient experiencing GERD?Lifestyle changes — Lifestyle changes are commonly recommended for adults with GERD. These might include raising the head of the bed, avoiding exposure to tobacco smoke, and losing weight. These changes might be helpful for some, but not all, children with mild GERD symptoms.
Which would be the proper nursing intervention for the disorder in GERD?Avoid placing the patient in supine position, have the patient sit upright after meals; instruct patient to avoid highly seasoned food, acidic juices, alcoholic drinks, bedtime snacks, and foods high in fat; elevate HOB while in bed. Enforce health education.
Which self care behavior would benefit a client with gastroesophageal reflux disease?These lifestyle changes can help ease the symptoms of GERD or even prevent the condition: quitting smoking. avoiding alcohol. losing weight if you are overweight.
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