Question

In: Nursing

Describe a patient that you have diagnosed with either GERD or PUD. Include the patient's demographics,...

Describe a patient that you have diagnosed with either GERD or PUD. Include the patient's demographics, complaints, and symptoms, as well as the diagnostics, treatment, and what patient education you would provide. If you selected GERD, indicate how it is similar to but can be differentiated from PUD. If you selected PUD, indicate how it is similar to but can be differentiated from GERD.

Expert Solution

GERD (Gastroesophageal Reflux Disease):

Physiologic process of effortless movement of gastric contents into the esophagus. This process happens to all.
Pathological is when this process causes damage to the esophagus, oropharynx, larynx or respiratory tree.

• Atypical symptoms:

- Chest pain

- Dental erosions

- Asthma/Cough

- Hoarse Sore throat

- Aspiration

- Laryngeal ulcerations

- Stridor

• Classical symptoms:

-Heartburn

- Regurg

- Water Brash(hypersalivation that can occur before vomitting)

• Alarming signs of GERD:

- Dysphagia
- Wt. loss
- Hematemesis
- Lymphadenopathy
- Anemia
- FOBT(Fecal Occult Blood Test) + Bleeding

• Investigation/ diagnostic tests:

- Endoscopy and biopsy: normal appearance but abnormal bx, friable mucosa, erosions, ulcers, strictures.
- Barium swallow usually for dysphagia
- Ambulatory 24 pH assessment usually for atypical or unresponsive
- Manometrics to test for motility or LES pressure(most surgeons want this before they cotemplate surgery.)

• Treatment:

- Antacids
- Histamine 2 Antagonists
- Proton Pump Inhibitors
- Sucralfate
- Motility agents
- Surgery- fundalplication

• Health education for GERD:

- Avoid caffeine, tobacco, alcohol, NSAIDS, ASA
- No bedtime snacking
- Smaller more frequent meals
- Avoid mints, large meals, citrics, chocolate, fat
- Elevate head of bed
- Loose weight, avoid tight fitting garments
- Check medications

• Differences between GERD and PUP (Peptic Ulcer Disease):
- Burning sensation rising from the stomach into the chest or towards the neck, it is due to GERD but Peptic ulcer disease pain or discomfort localized in the center part of the abdomen.

Symptoms appears same but there are particular differences which distinguish both of them.

Nightingale answered 2 years ago

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