What term should the nurse use to document a detached blood clot?

Choice A reason:
Loss of muscle tone at the lower esophageal sphincter (LES) is the primary cause of GERD. The LES normally prevents stomach contents from refluxing into the esophagus. When its tone is reduced, acidic gastric contents can flow back, leading to symptoms such as heartburn, regurgitation, and potential damage to the esophageal lining. Factors contributing to LES dysfunction include obesity, hiatal hernia, and certain dietary habits.
Choice B reason:
Sympathetic nerve stimulation is not a cause of GERD. The autonomic nervous system plays a role in regulating digestive functions, but GERD is primarily a mechanical issue involving the LES and is not directly related to sympathetic nervous activity.
Choice C reason:
Fibrosis of the lower third of the esophagus is typically associated with conditions such as scleroderma, which can lead to esophageal motility disorders. While fibrosis might contribute to esophageal dysfunction, it is not the primary cause of GERD.
Choice D reason:
Reverse peristalsis of the stomach is not a mechanism for GERD. GERD results from dysfunction of the LES, not from the backward movement of stomach contents due to altered motility.

Choice A reason:
While decreased cerebral blood flow can contribute to various neurological conditions, it is not the primary cause of hepatic encephalopathy. Hepatic encephalopathy is primarily associated with liver dysfunction rather than cerebrovascular issues. Thus, this choice is incorrect.
Choice B reason:
Impaired ammonia metabolism is the primary cause of hepatic encephalopathy. When the liver is unable to adequately convert ammonia to urea due to chronic liver disease, ammonia accumulates in the bloodstream. This leads to toxic effects on the brain, resulting in the symptoms of hepatic encephalopathy. Therefore, this choice accurately reflects the underlying pathophysiology of the condition.
Choice C reason:
Hyperbilirubinemia and jaundice are common in liver disease but are not the primary causes of hepatic encephalopathy. These conditions result from impaired bilirubin metabolism and do not directly lead to the neurological manifestations seen in hepatic encephalopathy. Therefore, this choice is incorrect.
Choice D reason:
Fluid and electrolyte imbalances can occur with chronic liver disease but are not the primary cause of hepatic encephalopathy. While they may exacerbate the condition, the main issue is the accumulation of ammonia due to impaired liver function. Hence, this choice is incorrect.