Author Question: The nurse is aware that which factors are related to the development of gastroesophageal reflux ... (Read 33 times)

DelorasTo · **on:** Jun 25, 2018

The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD)? (Select all that apply.)

a. Delayed gastric emptying
b. Eating large meals
c. Hiatal hernia
d. Obesity
e. Viral infections

Question 2

The following data relate to an older client who is 2 hours postoperative after an esophagogastrostomy:

Physical Assessment
Vital Signs
Physician Orders
Skin dry
Urine output 20 mL/hr
NG tube patent with 100 mL brown drainage/hr
Restless
Pulse: 128 beats/min
Blood pressure: 88/50 mm Hg
Respiratory rate: 20 on ventilator
Cardiac output: 2.1 L/min
Oxygen saturation: 99
Normal saline at 75 mL/hr
Morphine sulfate 2 mg IV push every 1 hr PRN pain
Intake and output every hour
Vital signs every hour
Vancomycin (Vancocin) 1 g IV every 8 hr
What action by the nurse is best?
a.
Administer the prescribed pain medication.
b.
Consult the surgeon about a different antibiotic.
c.
Consult the surgeon about increased IV fluids.
d.
Have respiratory therapy reduce the respiratory rate.

itsakadoozi · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A, B, C, D
Many factors predispose a person to GERD, including delayed gastric emptying, eating large meals, hiatal hernia, and obesity. Viral infections are not implicated in the development of GERD, although infection with Helicobacter pylori is.

Answer to Question 2

ANS: C
This client's vital signs, cardiac output, dry skin, and urine output indicate hypovolemia or possible hypotension resulting from pressure placed on the posterior heart during surgery. The client needs more fluids, so the nurse should consult with the surgeon about increasing the fluid intake. The client may be restless as a result of the hypotension and may not need pain medication at this time. There is no reason to request a different antibiotic. The respiratory rate does not need to be adjusted.