Clinical Case: GI Diet Therapy
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In this assignment you will review a case that deals with a client who has GERD.
Mrs. G. is a 45-year-old female arrives at the emergency department where you are working with complaints of burning pain in her chest and throat and a sour taste in her mouth. She states this pain has been going on for years after she eats certain foods. She has a large, extended family and does all of the cooking. She is Hispanic and likes to cook her special recipes because she believes that “these foods are good for herself and her family.” She is very proud of her cooking and believes that is one of her main contributions to her family. She has never been sick and does not like to take pills.
She is examined by the emergency room doctor and diagnosed with Gastroesophageal Reflux Disease (GERD). The doctor has ordered medication for you to administer. These medications include a proton pump inhibitor (Prilosec), and a Histamine 2 blocker (Pepcid). He also prescribes the proton pump inhibitor to be taken at home for the next two weeks. Mrs. G. starts to feel better and is ready for discharge. You will be providing the client teaching and discharge instructions about GERD.
In your discussion about GERD include:
· Dietary suggestions you would make
· What foods and liquids she should avoid
· What changes she should make
· Barriers she will face in making these changes and how they can be overcome
Include APA formatted references if used.
Please make an initial post by midweek, and respond to at least two other student’s posts with substantial details that demonstrate an understanding of the concepts and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials, be sure to provide proper attribution and/or citation.
Steph 1st response
Providing discharge instructions for Mrs. G means discussing what causes GERD and some habits that might worsen it. As a nurse responsible for providing client education and discharge instructions for Mrs. G., my priority is to explain to her what causes GERD so we can manage it better (Schlenker et al., 2019). I will ensure she understands that certain foods and lifestyle habits could make it worse, while changing both will aid in managing this condition effectively. Moreover, I will offer insights on prescribed medications like proton pump inhibitors and histamine 2 blockers and how they help address GERD. Regarding dietary recommendations tailored towards reducing the intensity and frequency of acid reflux episodes associated with GERD, I will advise avoiding greasy, fatty fried, or highly spiced food choices due to their known triggers on GERD episodes (Schlenker et al., 2019). Instead, switching up with low-fat, high-fiber meal plans consisting of whole grains, fruits, vegetables, and lean protein sources are encouraged options with smaller portion sizes but eaten frequently throughout the day instead of heavy ones, which increase pressure on the lower esophageal sphincter and eventually worsen GERD symptoms.
Furthermore, Mrs. G.’s potential improvement in managing GERD may hinge on reducing the consumption of specific liquids like alcohol, coffee, or carbonated beverages, which can escalate stomach acid production, exacerbating the condition’s symptoms (Kröner et al., 2021). Instead, I would recommend that Mrs. G. hydrate using water or non-citrus-based juices might prove more effective in quelling its impact on the body’s system. Additionally, bringing simple lifestyle changes into one’s daily routine alongside dietary alterations will help provide long-term relief against recurring episodes (Kröner et al., 2021). For instance, refraining from lying down directly following meals could decrease any risk of reflux, while quitting smoking or shedding excess weight is likely helpful in reducing the increased severity caused by those factors.
Though Mrs. G’s dedication to remedying GERD cannot be denied, various factors could impede progress. It is plausible that avoiding her favorite foods rich in fat or spice will be strenuous initially. For someone responsible for overseeing every aspect of their family’s diet, it would pose difficulties if they had to prepare individual meals. Additionally, the likelihood exists that taking medicines may not elicit a positive response. Mrs. G. has made it apparent that she dislikes swallowing pills. Instead, an approach enabling all members to adopt a healthier lifestyle is needed. To achieve this, the patient can enlighten her close ones on GERD and which foods exacerbate its symptoms. Modifying recipes would prove integral by using low-fat ingredients or avoiding certain spices altogether (Kröner et al., 2021). A key suggestion would be for Mrs. G to work with her family members when preparing GERD-friendly meals. Scheduling separate meal plans might also help avoid undue pressure in preparing something separately. Finally, the doctor should be a source of reassurance and answers to any doubts that Mrs.G might harbor regarding medication; therefore, I would advise Mrs.G to discuss any concerns or questions she may have with the doctor.
Shaki 2nd response
Gastroesophageal reflux disease, GERD, occurs when stomach contents regurgitate into the esophagus, causing clients to feel radiating burning pain, affecting their quality of life (Gilbert & Schlenker, 2019). As a nurse whose job is to provide health intervention and promotion, I would recommend specific diet and lifestyle changes to ease the client’s symptoms, thus allowing the prescribed medications to work at their full potential.
Change may not be easy for many people, especially when it involves food. As with Mrs. G, who takes pride in cooking for her family using special recipes, I want to be sure not to offend her. I would acknowledge her background and culture, using therapeutic communication to convey the importance of implementing necessary changes. Although some things should be avoided, first, I would let her know she can still make her family recipes using modified versions of the same recipes, making it more likely that she will be agreeable to change. Her recipes can still taste great, but because of the GERD, low-fat options are best (Gilbert & Schlenker, 2019). I would also recommend that she avoids alcohol, as Pepcid increases the chances of intoxication, as well as chocolate, which contains caffeine and could lead to tremors, insomnia, and heart palpitations (Gilbert & Schlenker, 2019). She will also have to make a few changes which include making sure she eats earlier dinners, refraining from smoking, not lying down after eating, and elevating the head of her bed when resting, as symptoms of GERD may be exacerbated when lying down (Gilbert & Schlenker, 2019). I would also alert her that Prilosec can inhibit iron, selenium, and Vitamin B12 absorption if the Vitamin B12 is derived from food (Gilbert & Schlenker, 2019). She may initially find it challenging to change her diet, especially since her cooking is tied to health, pride, and family traditions. I will assure her that small changes make a big difference, that if she needs help, she can reach out, and that I could also contact her to see if the changes alleviate her symptoms.