Mrs.
Robinson is a 66-year-old female who presented to the emergency department with
wheezing, difficulty breathing, right-sided chest pain with deep inspiration,
nausea, and vomiting. She stated that she was in her usual state of health
until she awoke at 3:00 a.m. with wheezing and was not able to go back to
sleep. She was nauseous and vomited a small amount of green, blood-stained
emesis. A chest x-ray was done and showed an infiltrate in the right anterior
lung base with chronic pleural effusion. Mrs. Robinson’s medical history
includes asthma, gastroesophageal reflux disease (GERD) for the past 3 years,
and recurring pneumonia. She weighs 170 lbs. with a BMI of 29.2. She was
started on albuterol (Ventolin) nebulizer treatments and levofloxacin
(Levaquin) intravenously in the emergency department.
Mrs.
Robinson was admitted to the medical unit with a diagnosis of pneumonia due to
recurrent aspiration related to the GERD. She remained on the levofloxacin
(Levaquin) for infection and was prescribed lansoprazole (Prevacid) and
ranitidine (Zantac) to prevent reflux.
1.
Explain what GERD is and discuss six risk factors that increase the risk
of developing GERD.
2. Explain two of the factors that contributed
to the development of Mrs. Robinson’s GERD.
3. If untreated, what are three of the possible
complications of GERD?
4. Discuss how the following medications work to
reduce the symptoms of reflux.
a.
Lansoprazole (Prevacid)
b. Ranitidine (Zantac)
5. Why are antacids not used to manage GERD?
6. Name 6 foods and medications that may
precipitate an episode of reflux esophagitis?
7. How does Mrs. Robinson’s weight affect her reflux?
8. Describe 3 lifestyle/nutritionrecommendations you could make to Mrs. Robinson to help
allieviate her GERD without the use of medications.
Make
sure your writing is clear, organized and easy to understand and follow.
Check
your work for spelling, grammar and punctuation.
Check
the Rubric below for the grading criteria.
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