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?