A nurse is providing education to a client with GERD (gastroesophageal reflux disease). The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend?

Reintroducing foods that intensify symptoms one at a time

Promoting intake of food and fluids 1 to 2 hours before bedtime

Maintaining an upright position following meals

Increasing the amount of carbonated beverages

Answer and Explanation

The Correct Answer is C

Choice A reason: Reintroducing foods that intensify symptoms one at a time is not an intervention that the nurse would recommend for a client with GERD. Foods that can trigger or worsen GERD symptoms include spicy, acidic, fatty, or fried foods, chocolate, coffee, alcohol, mint, garlic, and onion. The nurse would advise the client to avoid or limit these foods, not to reintroduce them.

Choice B reason: Promoting intake of food and fluids 1 to 2 hours before bedtime is not an intervention that the nurse would recommend for a client with GERD. Eating or drinking close to bedtime can increase the risk of acid reflux, as the stomach contents can flow back into the esophagus when the client lies down. The nurse would suggest the client to have smaller and more frequent meals, and to avoid eating or drinking at least 3 hours before bedtime.

Choice C reason: Maintaining an upright position following meals is an intervention that the nurse would recommend for a client with GERD. Keeping an upright posture can help prevent or reduce acid reflux, as gravity can help keep the stomach contents in place. The nurse would encourage the client to avoid bending, stooping, or lying down for at least 2 hours after eating.

Choice D reason: Increasing the amount of carbonated beverages is not an intervention that the nurse would recommend for a client with GERD. Carbonated beverages can increase the production of gas and stomach acid, which can cause bloating, belching, and acid reflux. The nurse would advise the client to drink water or other non-carbonated fluids, and to avoid drinking through a straw or chewing gum, which can also introduce air into the stomach.

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Correct Answer is B

Explanation

Choice A reason: Calling the doctor for more antiemetic medication is not the best intervention for the nurse to facilitate. Antiemetics are drugs that prevent or reduce nausea and vomiting, but they may have side effects such as drowsiness, dry mouth, or constipation. The nurse should first try non-pharmacological measures to relieve the patient's nausea, such as giving small sips of water, providing a cool and quiet environment, or using aromatherapy.

Choice B reason: Giving the patient small sips of tepid water is the best intervention for the nurse to facilitate. Water can help hydrate the patient and dilute any stomach acid that may cause irritation. Tepid water is water that is slightly warm, which can be more soothing than cold or hot water. Small sips can prevent the patient from swallowing too much air, which can worsen nausea and vomiting.

Choice C reason: Helping the patient lay supine is not a good intervention for the nurse to facilitate. Supine means lying flat on the back, which can increase the risk of aspiration, or inhaling food or fluids into the lungs. Aspiration can cause pneumonia, a serious lung infection. The nurse should help the patient lay on their side, with their head elevated, to prevent aspiration and reduce pressure on the stomach.

Choice D reason: Showing the patient how to use the patient-controlled analgesia is not a relevant intervention for the nurse to facilitate. Patient-controlled analgesia is a system that allows the patient to self-administer pain medication through an IV pump. It has nothing to do with nausea and vomiting, and may even cause them as side effects. The nurse should monitor the patient's pain level and adjust the analgesia settings as needed, but not as a way to treat nausea.

A. Drink a carbonated beverage before bed B. Increase fatty foods one at a time C. Elevate the head of the bed when sleeping D. Eat dinner late in the evening

Correct Answer is C

Explanation

Choice A reason: This is not a correct instruction because drinking a carbonated beverage before bed can worsen the reflux symptoms by increasing the gastric pressure and the production of gas.

Choice B reason: This is not a correct instruction because increasing fatty foods can worsen the reflux symptoms by delaying the gastric emptying and relaxing the lower esophageal sphincter (LES), which allows the stomach acid to flow back into the esophagus.

Choice C reason: This is a correct instruction because elevating the head of the bed when sleeping can help prevent the reflux symptoms by using gravity to keep the stomach contents from flowing back into the esophagus.

Choice D reason: This is not a correct instruction because eating dinner late in the evening can worsen the reflux symptoms by increasing the amount and acidity of the stomach contents, which can easily flow back into the esophagus when lying down. The client should avoid eating within 3 hours of bedtime.

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