Introduction

Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux

disease (GORD), gastric reflux disease, or acid reflux disease is chronic
symptoms ormucosal damage caused by stomach acid coming up from
the stomach into the esophagus. A typical symptom is heartburn.

GERD is usually caused by changes in the barrier between the stomach and the
esophagus, including abnormal relaxation of the lower esophageal sphincter,
which normally holds the top of the stomach closed; impaired expulsion of gastric
reflux from the esophagus, or a hiatal hernia. These changes may be permanent
or temporary ("transient").

Another kind of acid reflux, which causes respiratory and laryngeal signs and
symptoms, is called laryngopharyngeal reflux (LPR) or "extraesophageal reflux
disease" (EERD). Unlike GERD, LPR is unlikely to produce heartburn, and is
sometimes called silent reflux.
Objectives
Client’s Profile

A. Socio-Demographic Date

Patient X is a 50 years old female who lives with his family at

Bignay, Valenzuela. She has 5 children and she is a housewife.

B. Health Pattern Assessment

[] Past Medical History

According to the patient, she felt the symptoms of GERD last
December 26 of last year, vomiting, dizziness, heartburns and fever. The
patient is admitted to Jose Reyes Medical because of the symptoms she
felt. And again this January 23, she was brought to Jose Reyes because
of the same symptoms.

[] History of the Present Illness

The patient brought to the Emergency Room of Valenzuela Medical

Center because of the symptoms of vomiting, dizziness, heartburns and
fever.

C. Family – Medical History

The patient has history of hypertension in the paternal side of the

family.

D. Social History

The patient is a housewife; she was given by her children for her
financial needs.
Pathology- Physiology
Drug Study

GENERICNAME: Hydralazine HCL

Brandname: Apresoline
Drug classification: Vasodilator drug
MECHANISM INDICATIONS CONTRA- ADVERSE NURSING
INDICATIONS EFFECTS responsibiliti
es
>increases gua >inc. cardiac >not for >Diarrhea >use
nosine output patients with >Compens cautiously in
monophosphat >Inc. Pulse rate high BP atory elderly
e levels, >increase plasm >with open tachycardia patients
decreasing the a renin concentr wounds >Headach >monitor
action of ation >with sclerosis e blood
the second >Pounding pressure
messenger IP3, heartbeat >watch for
limiting calcium >Nausea over-used of
release from and the drug
the sarcoplasmi vomiting
c reticulumof
smooth muscle.
This results in
an vessel
relaxation. It
dilates
arterioles more
than veins.
GENERICNAME: Dipenhydramine HCL
Brandname: Benadryl
Drug classification: anti-histamine
MECHANISM INDICATIONS CONTRA- ADVERSE NURSING
INDICATIONS EFFECTS responsibilities
> blocks the >relieves >don’t give when >sleepiness >stop taking
allergies, patient is take a >fatigue alchoholic
effects of the wateryeyes, MOAI >dry mouth drinks
naturally sneezing, >with glaucoma >difficulty in >Watch for
occurring itching, >stomach ulcer urinating dizziness as
rashes, >enlarged adverse effect
chemical
motion prostate
histamine in sickness >hyperthyroidism
the body. >use for >asthma
emergency
cases
Surgical Intervention

A. incision and drainage

- Evacuation of development of pus in the affected area

B. anterior decompression spinal fusion

- This is a major surgery which utilizes a skin incision over the front
of the body to approach the spine

Indication
• Degenerative conditions causing compression of spinal cord or spinal
nerves, e.g. intervertebral disc prolapse, posterior vertebral body
osteophytes
• Instability of the spine
• Spine fracture
• Spinal tumour
• Spinal infection (usually tuberculous or bacterial)
• Spinal deformity
• Miscellaneous conditions causing spinal cord or spinal nerve damage

The Procedure
• The skin incision is usually on one side in the front of the body
• Surgery is performed depending on individual patient
• A piece of bone will be harvested from the ilium, fibula or a rib to fill the
defect at the spinal column (in special conditions synthetic material or
allograft may be used)
• Internal fixation devices such as plates and screws may be used if
necessary