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HAVE YOU EVER…. Harlene Castillo Christine Valdez Claudia Vasquez November 17, 2010 NURS 120. GERD & Gastroenteritis. DEFINITION. GERD occurs after eating a meal Acidic contents refluxes or moves upwards towards the esophagus.
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Harlene Castillo Christine Valdez Claudia Vasquez November 17, 2010 NURS 120 GERD & Gastroenteritis
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 Patterns GERD • Nutritional Metabolic Patterns • Imbalanced nutrition • Impaired swallowing GASTROENTERITIS • Nutritional Metabolic Pattern • Nausea & vomiting • Elimination Pattern • Diarrhea
Nursing Process ASSESSMENT • 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 eating • Eating large meals • Drinking alcohol • Smoking • Fatty foods • Caffeine • Chocolate
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?
