Question

A 45-year-old male client comes to the nurse practitioner (NP) stating he wakes often at night with coughing and burning he describes as heartburn. He drinks 1-2 alcoholic beverages per evening, usually with distilled liquor, and then wine with dinner. He eats heavy dinners with dessert. He prefers mint ice cream and coffee for dessert. The NP prescribes a regimen with omeprazole (Prilosec) every morning and Maaloz 30 mL qid.

How will you instruct the client about gastroesophageal reflux disease and its relationship to symptoms?

What will you instruct the client about his diet, particularly the evening meal?

How will you instruct the client about his medications?

Answer 1

Gastroesophageal reflux disease(GERD) is a condition where acid from the stomach comes up into esophagus. Many people experienced in occasionally. Some people experiences regularly when they eat certain type of food. So better to avoid these kind of food.

In this patient's case his food habits causing heart burning. Regular GERD is not good because it is very harmful to esophagus, cause tissue damage. It will affect disfunctioning of the valve at the top of the stomach. In this patient, his unhealthy eating causes GRED like overeating, eating particular foods, use of alcohol, unhealthy foods.
  
Better to eat moderate amount of foods in night. Avoid overeating. Stop eating two to three hours before sleeping. Quit or avoid alcohol use. Need to change sleeping position that head slightly elevated. Avoid certain foods that causing GERD. That include spicy foods, coffee, alcoholic drinks, mint, chocolate and tomato.

First GERD treat with medications. Proton pump inhibitors are one of the main treatment for GERD. Here omeprazole is a Proton pump inhibitor every morning. Maaloz 30 mL qid. This medication is used to get relief for stomach upset, heartburn, and indigestion.

Seek medical attention for any problems exits like weight loss, difficulty or pain when swallowing, dark-colored stools, or vomiting.