Gastroesophageal Reflux Disease (GERD) Nursing Care Plan Notes


  • Gastroesophageal reflux disease (GERD) is excessive reflux of hydrochloric acid into the esophagus.
Risk Factors
  • Incompetent lower esophageal sphincter (LES), pyloric stenosis or a motility disorder.
  • A weak or incompetent LES allows backward movement of gastric contents into the esophagus; decreased esophageal peristalsis and salivary function impair clearance of the refluxed acid, resulting in mucosal injury to the esophagus.
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Assessment/Clinical Manifestations/Signs and Symptoms
  • Pyrosis (i.e. burning sensation in the esophagus)
  • Regurgitation of sour-tasting secretions
  • Dysphagia (i.e. difficulty swallowing) and odynophagia ( i.e pain on swallowing)
  • Symptoms mimicking those of a heart attack
Nursing Management
Teach the client to avoid factors that increase lower esophageal irritation.
  • Eat a low-fat, high-fiber diet
  • Avoid irritants, such as spicy or acidic foods, alcohol, caffeine, and tobacco, because they increase gastric acid production.
  • Avoid food or drink 2 hours before bedtime or lying down after eating
  • Elevate the head of the bed on 6” to 8” bocks
  • Lose weight if necessary
If symptoms persist, prepare the client for surgical repair, which includes a funduplication (i.e. wrapping a portion of the gastric fundus around the sphincter area of the esophagus)
Administer medications, which may include antacids, histamine-receptor antagonists, and proton-pump inhibitors.