Author Question: A patient undergoes endoscopy, and a diagnosis of erosive esophagitis is made. The patient does not ... (Read 63 times)

rlane42

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A patient undergoes endoscopy, and a diagnosis of erosive esophagitis is made. The patient does not have health insurance and asks the primary care NP about using OTC antacids such as Tums. The NP should tell the patient that Tums:
 
  a. can help to heal erosions in esophageal tissue.
  b. do not help reduce symptoms of erosive esophagitis.
  c. neutralize stomach acid as well as proton pump inhibitors (PPIs).
  d. help reduce symptoms in conjunction with PPIs.

Question 2

A patient who has gastroesophageal reflux disease (GERD) undergoes an endoscopy, which shows a hiatal hernia. The patient is mildly obese. The patient asks the primary care nurse practitioner (NP) about treatment options.
 
  The NP should tell this patient that: a. a fundoplication will be necessary to correct the cause of GERD.
  b. over-the-counter (OTC) antacids can be effective and should be tried first.
  c. elevation of the head of the bed at night can relieve most symptoms.
  d. a combination of lifestyle changes, medications, and surgery may be necessary.



Rilsmarie951

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Answer to Question 1

D
Antacids reduce symptoms but do not have a significant effect on healing of erosions or esophagitis. If the patient has severe symptoms, has found treatment for milder symptoms to be ineffective, or has experienced erosion that is documented by endoscopy, he or she should be started on a PPI.

Answer to Question 2

D
People with GERD often have hiatal hernia, but this is not the cause of GERD. The approach to treatment of GERD may include lifestyle changes, medications, and surgery. OTC antacids are sometimes used but are rarely used as first-line treatment.



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