Gastroesophageal reflux disease or simply GERD is the excessive backflow of gastric or duodenal contents, or both into the esophagus and past the lower esophageal sphincter (LES) for a sustained length of time without associated belching or vomiting.
Nursing Care Plans
Nursing care planning goals of gastroesophageal reflux disease (GERD) involves teaching the patient to avoid situations that decrease lower esophageal sphincter pressure or cause esophageal irritation.
The following are seven (7) nursing care plans for gastroesophageal reflux disease (GERD):
- Imbalanced Nutrition: Less Than Body Requirements
- Acute Pain
- Imbalanced Nutrition: More Than Body Requirements
- Risk for Aspiration
- Deficient Knowledge
- NEW: Anxiety (Pediatric)
- NEW: Risk for Injury (Pediatric)
Imbalanced Nutrition: Less Than Body Requirements
Imbalanced Nutrition: Less Than Body Requirements: The state in which an individual who is not on NPO, experiences or is at risk for inadequate intake or metabolism of nutrients for metabolic needs with or without weight loss.
May be related to
- inability to intake enough food because of reflux
- increased metabolism caused by disease process
- early satiety
- heartburn
Possibly evidenced by
- inadequate food intake
- altered taste
- weight loss
- decreased peristalsis
- muscle mass loss
- nausea and vomiting
- abdominal pain or discomfort
- intolerance of fatty foods
- epigastric pain after eating
- heartburn
- regurgitation
- dysphagia
Desired Outcomes
- Patient will ingest daily nutritional requirements in accordance to his activity level and metabolic needs.
| Nursing Interventions | Rationale |
|---|---|
| Accurately measure the patient’s weight and height. | For baseline data. |
| Obtain a nutritional history. | Determining the feeding habits of the client can provide a basis for establishing a nutritional plan. |
| Encourage small frequent meals of high calories and high protein foods. | Small and frequent meals are easier to digest. |
| Instruct to remain in upright position at least 2 hours after meals; avoiding eating 3 hours before bedtime. | Helps control reflux and causes less irritation from reflux action into esophagus. |
| Instruct patient to eat slowly and masticate foods well. | Helps prevent reflux. |
| Prepare the patient for the following diagnostic procedures: | |
| Complete blood count | To identify the presence of anemia that must be ruled out |
| Cardiac enzymes | To rule out myocardial pain related to the atypical pain felt with GERD |
| Serum iron | To identify presence of iron-deficiency anemia |
| Gastrin levels | To identify toxicity of proton pump inhibitors or to diagnose Zollinger-Ellison syndrome |
| Gastric acid secretory analysis | To determine if failure with pharmacologic agents is caused by inadequate suppression of gastric acid secretion, which may signify bile reflux or pill-induced disease |
| Upper gastrointestinal endoscopy | Used to identify the type and extent of tissue damage. |
| Barium swallow | Can be used to identify structures and Hiatal hernias |
| Esophageal pH monitoring | Used to document pathologic acid reflux, especially for patients who have atypical symptoms. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
More nursing care plans related to gastrointestinal disorders:
- Appendectomy | 4 Care Plans
- Cholecystectomy | 12 Care Plans
- Cholecystitis and Cholelithiasis | 4 Care Plans
- Gastroenteritis | 4 Care Plans
- Hemorrhoids | 3 Care Plans
- Hepatitis | 7 Care Plans
- Ileostomy & Colostomy | 10 Care Plans
- Inflammatory Bowel Disease | 7 Care Plans
- Intussusception | 3 Care Plans
- Liver Cirrhosis | 8 Care Plans
- Pancreatitis | 8+ Care Plans
- Peritonitis | 6 Care Plans
- Peptic Ulcer Disease | 5 Care Plans
- Subtotal Gastrectomy | 2 Care Plans
I am surprised that there has not been a care plan for Constipation. That’s what I was looking for. Thanks Vicky
Hello, for click here for the constipation nursing care plan. Thanks!