RN Nursing · Gastroesophageal Reflux Disease · Practice question
A nurse is assessing a client who has a sliding hiatal hernia. Which of the following findings should the nurse expect?
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✓
Heartburn
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Breathlessness
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Constipation
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Abdominal cramping
Answer & explanation
Correct: Heartburn
A sliding hiatal hernia occurs when part of the stomach slides upward through the esophageal hiatus into the thoracic cavity. This anatomical displacement allows gastric contents to reflux into the esophagus, causing the hallmark symptom of heartburn (pyrosis), which is a burning sensation in the chest or epigastric area that often worsens after eating, lying down, or bending forward. Heartburn is the most consistent and expected finding in a client with a sliding hiatal hernia. Breathlessness can occur with a paraesophageal hiatal hernia — a less common type in which the fundus herniates alongside the esophagus — because the herniated stomach can compress respiratory structures; however, breathlessness is not characteristic of the sliding type. Constipation is not a primary manifestation of hiatal hernia; it is more associated with dietary factors, immobility, or other gastrointestinal disorders. Abdominal cramping is also not a typical presentation of a sliding hiatal hernia; it is more associated with inflammatory bowel conditions or obstruction. The primary symptom of sliding hiatal hernia is reflux-related heartburn due to lower esophageal sphincter incompetence caused by the stomach's displaced position.
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