Gastroesophageal Reflux

Description
1. the back flow of gastric and doudenal contents into the esophagus
2. caused by an incompetent lower esophageal sphincter, pyloric stenosis or a motility disorder
3. symptoms may mimic those of a heart attack
Assesment
a. Pyrosis, dyspepsis, regurgitiation, pain and difficulty with swallowing, hypersalivation
Implementation
1. instruct tha patient to avoid factors that decrease lower esophageal sphincter pressure or cause esophageal irritation.
2. instruct the client to eat a low fat, high fiber diet: avoid caffeine, tobacco and carbonated beverages, to avoid eating and drinking 2 hours before bedtime, to avoid wearing tight clothes, and to elevate the head of bed on 6 to 8 inch block
3. avoid use of anticholinergics which delay stomach emptying
4. instruct the client regarding prescribed medications such as antacids, histamine, H2 receptor antagonist or gadtric acid pump inhibitors
5. indtruc the client regarding the administration of prokinetic medications, if prescribed which accelerate gastric emptying
6. surgery involves fundoplication ( wrapping a portion of the gastric fundus aroud the sphincter area of the esophagus)

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