Question

A client has completed a gastroscopy procedure. The gastroenterologist informs the client of a GERD diagnosis. Which teaching will the nurse recommend to be included in the discharge plans? A. Eat a bedtime snack nightly B. Recumbent position after meals C. Limit or eliminate alcohol and tobacco D. Eat regular meals three times a day

Short answer

Answer: Limit or eliminate alcohol and tobacco consumption.

Step-by-step solution

Understanding GERD

GERD (Gastroesophageal Reflux Disease) is a condition that occurs when stomach acid frequently flows back into the esophagus, causing irritation. To help the client manage this condition, some lifestyle changes need to be made.

Analyzing Option A

Option A suggests having a bedtime snack nightly. Eating close to bedtime can make GERD symptoms worse since lying down after eating can cause the stomach acid to flow more easily into the esophagus. Thus, this option is not helpful for the client.

Analyzing Option B

Option B suggests adopting a recumbent position after meals. This means lying down or reclining after eating, which is not a helpful suggestion for someone with GERD because it makes it easier for stomach acid to flow back into the esophagus, worsening the condition.

Analyzing Option C

Option C advises limiting or eliminating alcohol and tobacco consumption. Both alcohol and tobacco use are known to relax the lower esophageal sphincter, which is responsible for stopping stomach acid from flowing back into the esophagus. Eliminating these substances can significantly improve GERD symptoms. Therefore, this option could be beneficial to the client.

Analyzing Option D

Option D suggests eating regular meals three times a day. Although having regularly timed meals can be helpful in managing GERD symptoms, it is not the most critical aspect of managing the condition. Other lifestyle changes, like avoiding trigger foods and eating smaller meals more frequently, may have a more significant impact on the client's condition.

Selecting the best option

Comparing all the options, Option C - Limit or eliminate alcohol and tobacco - is the most appropriate and useful recommendation for the client with a GERD diagnosis. It addresses significant contributing factors to the condition and by following this recommendation, the client is likely to see improvement in their symptoms.

Key concepts

Gastroscopy Procedure

A gastroscopy is an endoscopic procedure used to visualize the upper part of the gastrointestinal tract, which includes the esophagus, stomach, and duodenum. A flexible tube with a camera, called a gastroscope, is inserted through the mouth and guided down the throat.

A gastroscopy can help diagnose a variety of conditions such as Gastroesophageal Reflux Disease (GERD), ulcers, and cancer. It's a relatively safe procedure with minimal risks. During the procedure, patients may receive local anesthesia or sedation to minimize discomfort.

Preparation for Gastroscopy

Before undergoing a gastroscopy, patients are usually advised not to eat or drink for several hours. It's also important for patients to inform their healthcare provider about any medications they are taking, as some may need to be adjusted or temporarily stopped.

Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease, commonly known as GERD, is a long-term condition where stomach contents come back up into the esophagus resulting in symptoms or complications. Symptoms include heartburn, regurgitation, and difficulty swallowing.

Causes and Risk Factors

The main cause of GERD is the weakening or relaxation of the lower esophageal sphincter. Several factors can contribute to this, such as obesity, pregnancy, smoking, and certain foods.

Management Strategies

Treatment often involves lifestyle modifications such as dietary changes, weight loss, and avoiding lying down after eating. Medications like proton pump inhibitors or H2 blockers help reduce the production of stomach acid.

Nursing Discharge Teaching

Following the gastroscopy procedure and GERD diagnosis, nursing discharge teaching is crucial. This involves educating the patient about managing their condition at home to minimize symptoms and prevent complications.

Key recommendations include avoiding foods and beverages that can trigger reflux, such as spicy foods, caffeine, and chocolate. Nurses will stress the importance of not eating large meals or eating late in the evening. Elevating the head while sleeping can help prevent nighttime reflux.

Medication Adherence

Patients may be advised on the proper use of prescribed medications to manage symptoms. It's also essential for patients to understand the importance of follow-up appointments to monitor the condition and adjust treatments as necessary.