NCM116-RC (Group 2)

Activity#1

Instructions: Kindly provide the information (a-f) on the following disorders:

DISTURBANCES IN INGESTION

1. Gastroesophageal Reflux (GERD)

a. Clinical manifestation
• A burning sensation in your chest (heartburn), usually after eating, which might be
worse at night or while lying down
• Backwash (regurgitation) of food or sour liquid
• Upper abdominal or chest pain
• Trouble swallowing (dysphagia)
• Sensation of a lump in your throat
b. Diagnostic Test- Upper gastrointestinal (GI) endoscopy
c. Pathophysiology- The pathophysiology of GERD is multifactorial and is best explained by
various mechanisms involved, including the influence of the tone of the lower esophageal
sphincter, the presence of a hiatal hernia, esophageal mucosal defense against the
refluxate and esophageal motility
d. Medical/surgical management (kindly include the medications)-
Surgical
Fundoplication- The surgeon wraps the top of your stomach around the lower esophageal
sphincter, to tighten the muscle and prevent reflux.
LINX device-A ring of tiny magnetic beads is wrapped around the junction of the stomach
and esophagus.
Transoral incisionless fundoplication (TIF)-This new procedure involves tightening the
lower esophageal sphincter by creating a partial wrap around the lower esophagus using
polypropylene fasteners.
e. Nursing Management
• Eat a low-fat, high-fiber diet
• Avoid irritants, such as spicy or acidic foods, alcohol, caffeine, and tobacco,
because they increase gastric acid production.
• Avoid food or drink 2 hours before bedtime or lying down after eating
• Elevate the head of the bed on 6” to 8” bocks
• Lose weight if necessary
f. Make 2 NCP (Priority problem)
Assessment Diagnosis Planning Interventions Evaluations
Subjective esophagus mucosa After 6 hours of The head of the After 6 hours of
“sobrang sakit irritation-related acute nursing bed should be nursing
pong tiyan ko at pain as shown by stomach intervention, the placed on 4 to 8 intervention, the
mainit na pain, heartburn, client will report inches blocks. client the client
pakiramdam sa heartburn cough, and relieved of pain reported
dibdib ko” dysphagia are all Advise the client decreased of pain
Objective expressed verbally. to avoid food or as evidenced by
•sore throat drink 2 hours the pain scale
•cough before bedtime or from 9/10 into
•abdominal pain lying down after 2/10. Goal met
with scale of 8/10 eating
• heart burn
•regurgitation Encourage the
•mid patient to avoid
-thoracic activity and
bilateral back pain remain upright for
1 to 4 hours after
Vital signs each meal.
•bp: 130/80
•pr:92bpm •rr:20pbm Advise the patient
•bt:35.6 c to avoid tight
fitting clothes.

Instruct the
patient to eat
slowly and chew
food thoroughly.
Collaborative

Discuss with
family members
to provide patient
small, frequent
feedings.

Discuss with the

family members
the effect of
irritants such as
tobacco and
alcohol.

Discuss with the

family members
to avoid very hot
or cold foods,
spices, fats,
coffee,
chocolates, and
citrus juices.
Assessment Diagnosis Planning Intervention Evaluation
Subjective: Imbalanced After 4 hours of Obtain a After 6 hours of
“di ako nakakakain ng Nutrition: Less nursing nutritional nursing intervention,
maayos ng isang buwan Than intervention, the history. the client verbalized
at feeling ko Body client will change in eating
nangangayayat na ako” Requirements verbalize change Advise the client habits as evidenced
related to lack in eating habits to to avoid food or by eating small,
Objective: food intake due to meet his drink 2 hours frequent meal;
• sore throat reflux as nutritional needs. before bedtime or eating slowly and
• cough evidenced by lying down after chewing food
• abdominal pain dysphagia, eating thoroughly; and
• with scale of abdominal pain, avoiding irritants.
8/10 regurgitation, Encourage the Goal met.
• heart burn weight loss, patient to avoid
• regurgitation postprandial activity and
• mid-thoracic fullness and early remain upright for
bilateral back satiety I to 4 hours after
pain each meal.

Vital signs Advise the patient

•bp: 130/80 to avoid tight
•pr:92bpm fitting clothes.
•rr:20pbm
•bt:35.6 Instruct the
patient to eat
slowly and chew
food thoroughly.

Weigh the patient

daily.

Administer
medication as
prescribed
by the physician
and monitor the
patient regularly.

Collaborative
Discuss with
family members
to provide patient
small, frequent
feedings.
 DISTURBANCES IN DIGESTION
1. Peptic Ulcer Disease
a. Clinical manifestation-These symptoms include epigastric pain that worsens with
eating, postprandial belching and epigastric fullness, early satiety, fatty food
intolerance, nausea, and occasional vomiting.
b. Diagnostic Test-Endoscopy. Your doctor may use a scope to examine your upper
digestive system (endoscopy). During endoscopy, your doctor passes a hollow tube
equipped with a lens (endoscope) down your throat and into your esophagus, stomach
and small intestine. Using the endoscope, your doctor looks for ulcers.
c. Pathophysiology-Peptic ulcer disease is characterized by discontinuation in the inner
lining of the gastrointestinal (GI) tract because of gastric acid secretion or pepsin. It
extends into the muscularis propria layer of the gastric epithelium. It usually occurs in
the stomach and proximal duodenum.
d. Medical/surgical management (kindly include the medications)- antibiotics for two
weeks, as well as additional medications to reduce stomach acid, including a proton
pump inhibitor and possibly bismuth subsalicylate (Pepto-Bismol). Medications that
block acid production and promote healing.
e. Nursing Management
• Assessment for a description of pain.
• Assessment of relief measures to relieve the pain.
• Assessment of the characteristics of the vomitus.
• Assessment of the patient’s usual food intake and food habits.
f. Make 2 NCP (Priority problem)

Assessment Diagnosis Planning Intervention Evaluation

Subjective: Acute pain in r/t After 8 hours of Independent: Goal met, patient
"Sumasakit ang Chemical burn of nursing Note reports of has verbalized
Sikmura ko gastric mucosa interventions, the pain, including relief of pain.
pagkatapos patient will location, duration, >Demonstrated
kumain" as verbalize relief of intensity (0-10 relaxed body
verbalized by the pain. scale) posture and be
patient. >Demonstrate able to sleep/rest
relaxed body review elements appropriately.
Objective: posture and be that infuriate or
•Abdominal able to sleep/rest relieve discomfort.
•guarding appropriately
•Restlessness Determine and
•Facial grimacing restrict
Pain scale of food items that
7
out of 10 such discomfort
as spicy or
V/S carbonated
T: 37.4 °C beverages.
P: 68
R: 13 Encourage small
BP: 110/80 frequent meals.
Encourage patient
to assume
position and
comfort.

Assessment Diagnosis Planning Intervention Evaluation

Subjective: Acute pain related to the After 12 hours of •Assess for potential -After 12 hours of
-“sobrang sakit ng tyan effect of gastric acid nursing intervention, types of pain that nursing intervention,
ko” as verbalize by the secretion on damaged the patient will be may be affecting the goal was partially
patient. tissue able to Relief or client met patient stated
controlled episode of “decrease episode of
pain. pain”.
Objective: • Perform pain
-Self-report of intensity assessment each
using standardized pain time pain occurs.
scale [e.g. 7 out of 10) Document and
investigate changes
from previous
reports and evaluate
results of pain
interventions

-Instruct patient to
Avoid aspirin, which
is an anticoagulant,
and foods and
beverages that
contain acid-
enhancing caffeine

• Determine and
document presence
of possible
pathophysiological
and psychological
causes of pain (e.g.
abdominal
condition.)

-Administer
prescribed
medications as
ordered.