A patient who recently began having mild symptoms of GERD is ...

[scienceeasy]

A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patient's symptoms? (Select all that apply.)
 
  a. Avoiding hot, spicy foods
  b. Avoiding tobacco products
  c. Drinking a glass of red wine with dinner
  d. Eating a snack before bedtime
  e. Taking ibuprofen with food
  f. Using a small pillow for sleeping
  g. Wearing well-fitted clothing

Question 2

A patient who has been taking ranitidine (Zantac) continues to have pain associated with peptic ulcer. A noninvasive breath test is negative. Which treatment does the nurse expect the provider to order for this patient?
 
  a. Adding an over-the-counter antacid to the patient's drug regimen
  b. A dual drug therapy regimen
  c. Amoxicillin (Amoxil), clarithromycin (Biaxin), and omeprazole (Prilosec)
  d. Lansoprazole (Prevacid) instead of ranitidine

[carojassy25]

Answer to Question 1

ANS: A, B, E
Hot, spicy foods aggravate gastric upset, tobacco increases gastric secretions, and ibuprofen on an empty stomach increases gastric secretions, so patients should be taught to avoid these actions. Alcohol should be avoided since it increases gastric secretions. Eating at bedtime increases reflux, as does laying relatively flat to sleep, or wearing fitted clothing.

Answer to Question 2

ANS: D
This patient does not have H. pylori ulcer disease, so dual and triple drug therapy with antibiotics is not indicated. Patients who fail treatment with a histamine2 blocker should be changed to a proton pump inhibitor (PPI) such as lansoprazole. PPIs tend to inhibit gastric acid secretion up to 90 greater than the histamine antagonists.