Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 7 Gastrointestinal System^303



  • Endoscopy or esophagogastroduodenoscopy shows irritation from cellular
    changes of chronic reflux is also used to monitor patients with Barrett’s
    esophagus.

  • Esophageal manometry to measure lower esophageal sphincter tone.


TREATMENT



  • Administer antacids to neutralize acid; these medications act quickly:

    • Maalox, Mylanta, Tums, Gaviscon



  • Administer H2 (histamine type 2) blockers to decrease the production of acid:

    • ranitidine, famotidine, nizatidine, cimetidine



  • Administer proton pump inhibitors to reduce the production of acid:

    • omeprazole, esomeprazole, pantoprazole, rabeprazole, lansoprazole



  • Have patient eat six small meals rather than three large ones to reduce intra-
    abdominal pressure.

  • Surgery or endoscopic procedures may be performed to prevent the reflux
    from occurring.


NURSING DIAGNOSES



  • Risk for imbalanced nutrition: less than what body requires

  • Risk for imbalanced nutrition: more than what body requires

  • Acute pain

  • Chronic pain


NURSING INTERVENTION



  • Monitor vital signs.

  • Assess abdomen for distention, bowel sounds.

  • Teach about medication management.

  • Teach patient about lifestyle modifications:

    • Not to lie down after eating.

    • Elevate head of bed.



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