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
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
- Patient will ingest daily nutritional requirements in accordance to his activity level and metabolic needs.
|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 nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
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