1. HAVE YOU EVER…

2. GERD & Gastroenteritis
Harlene Castillo
Christine Valdez
Claudia Vasquez
November 17, 2010
NURS 120

3. 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.

4. 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

5. 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)

6. 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

7. GORDON’s Functional Patterns
GERD
Nutritional Metabolic Patterns
Imbalanced nutrition
Impaired swallowing
GASTROENTERITIS
Nutritional Metabolic Pattern
Nausea & vomiting
Elimination Pattern
Diarrhea

8. 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

9. DIAGNOSIS Acute Pain Deficit Knowledge Disturbed Sleep Pattern
Fluid Electrolyte Imbalance
Nutrition Imbalance

10. 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

11. 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

12. 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

13. 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.

14. 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?