A patient with GERD has a diagnosis of Barrett's esophagus has been admitted to your unit. You are writing a care plan for this patient. What information is essential to include?
A) He will need to undergo an upper endoscopy every 6 months to detect malignant changes.
B) Liver enzymes must be checked regularly, as H2 receptor antagonists may cause hepatic damage.
C) Small amounts of blood are likely to be present in his stools and should not cause concern.
D) Antacids may be discontinued when symptoms of heartburn subside.
Ans: A
Feedback: In the client with Barrett's esophagus, the cells lining the lower esophagus have undergone change and are no longer squamous cells. The altered cells are considered precancerous and are a precursor to esophageal cancer. In order to facilitate early detection of malignant cells, an upper endoscopy is recommended every 6 months. H2 receptor antagonists are commonly prescribed for clients with GERD; however, monitoring of liver enzymes is not routine. Stools that contain evidence of frank bleeding or that are tarry are not expected and should be reported immediately. When antacids are prescribed for clients with GERD, they should be taken as ordered whether or not the client is symptomatic.
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