GERD
the backwards flow of gastrointestinal contents into the esophagus
GERD nursing interventions
diet: restrict spicy and acidic and fatty
... [Show More] foods, eat 4-6 meals a day, avoid bedtime snacks, eat slowly and chew thoroughly
lifestyle: elevate HOC by 8-12 inches for sleep, stop smoking, monitor/avoid alcohol, weight reduction
drug therapy: antacids, histamine blockers
Hiatal Hernia
portion of the stomach enters into the esophagus through an opening or hiatus in diaphragm
types of hernias
Sliding (stomach slides into thoracic cavity when supine and into abd cavity when standing upright)
Paraesophageal: esophageal junction stays in place but fundus and greater curvature of stomach roll up through diaphragm
manifestations of a hiatal hernia
heart burn post meals and lying, dysphagia (difficulty swallowing)
Gastritis
Acute: rapid onset usually caused by dietary indiscretion (spicy, contaminated)
Chronic: prolonged inflammation caused by benign or malignant ulcers of the stomach of H. pylori
manifestations of gastritis
acute: abd discomfort, headache, n/v, hiccupping
chronic: epigastric discomfort, anorexia, heart burn after eating, intolerance to some foods, sour taste in mouth, n/v
peptic ulcer disease
erosion of GI mucosa resulting from digestive action of HCl acid and pepsin
types of peptic ulcers
acute: superficial erosion, minimal inflammation, short duration and resolves quickly when identified
chronic: muscular wall erosion with formation of fibrous tissue. Long duration.
Destroyers of mucosal barriers
H.pylori, aspirin, NSAIDs, corticosteroid, lifestyle factors (alcohol, coffee, smoking)
manifestations of peptic ulcers
pain in epigastrium 1-2 hours after meals and 2-5 hours post meals in duodenal ulcers (food aggravates pain)= antacids
gastric outlet obstruction manifestations
ulcer hx, pain progressing to generalized upper abd discomfort, vomitting is common, pain worsens at the end of the day, relief by burping, constipation is common complaint, loud peristalsis, stomach is grossly dilated
gastric outlet acute nursing interventions
treat symptoms, provide regular mouth care, cleanse and lubricate nares for NG tube, VS hourly, I/O
gastric outlet complications
perforation and hemorrhage
j tube
this is inserted into the jejunum
g tube
this is intserted into the stomach
nursing care for J/G tubes
pt teaching and prep, tube insertion, confirming placement, securing the tube, monitoring the placement, monitoring the patient, maintaining tube function, oral and nasal care, monitoring/preventing and managing complications and tube removal [Show Less]