A nurse is reinforcing teaching about disease management with client who has GERD. Which of the following statements should the nurse make?

"You should lay down for 1 hour following . meal."

"You should only drink 2 cups of coffee per day."

"You should elevate the head of the bed while sleeping."

"You should eat three large meals and two snacks per day."

Answer and Explanation

The Correct Answer is C

A) "You should lay down for 1 hour following a meal.":
Laying down after eating can exacerbate GERD symptoms by promoting acid reflux. The nurse should advise the client to remain upright for at least 30 minutes after eating to prevent reflux. Lying down increases the likelihood of gastric contents moving back into the esophagus.

B) "You should only drink 2 cups of coffee per day.":
Caffeine is a known trigger for GERD and can relax the lower esophageal sphincter, increasing the risk of acid reflux. The nurse should suggest limiting or avoiding coffee altogether, rather than recommending a specific quantity, as even small amounts may aggravate symptoms.

C) "You should elevate the head of the bed while sleeping.":
Elevating the head of the bed is a common and effective strategy for managing GERD. This helps prevent acid reflux during sleep by utilizing gravity to keep stomach contents from flowing back into the esophagus. A common recommendation is to elevate the head by 6-8 inches using blocks or a wedge pillow.

D) "You should eat three large meals and two snacks per day.":
Eating large meals can increase intra-abdominal pressure and promote acid reflux in clients with GERD. The nurse should recommend smaller, more frequent meals to reduce the risk of reflux and improve symptom control.

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Correct Answer is A

Explanation

A) Facial erythema:
Facial erythema is commonly seen in children with pertussis due to the intense coughing fits that are characteristic of the disease. The child may experience bursts of violent coughing, which can lead to a flushed appearance, especially in the face, due to increased pressure during coughing. This manifestation is a common and expected sign in children with pertussis.

B) Peeling of the hands and feet:
Peeling of the hands and feet is not a typical manifestation of pertussis. This is more commonly associated with conditions such as toxic shock syndrome or Kawasaki disease. Pertussis primarily presents with respiratory symptoms such as coughing and a characteristic "whooping" sound, not peeling skin.

C) Fever:
While a mild fever may occur in some children with pertussis, it is not the most prominent symptom. Pertussis is more often characterized by severe coughing fits, which can cause vomiting and a distinctive "whooping" sound, particularly during the paroxysmal stage. Fever is typically mild and not the hallmark of the disease.

D) Beefy, red tongue:
A beefy, red tongue is not a typical finding in pertussis. This symptom is more commonly seen in conditions such as scarlet fever or vitamin B12 deficiency. Pertussis primarily presents with respiratory symptoms like severe coughing and difficulty breathing, and does not typically affect the tongue in this manner.

A. Mix the 2 medications together prior to administration. B. Add the medications to a small amount of theformula. C. Flush the tube with at least 30 mL of sterile water prior to administering the medications. D. Connect the NG tube to suction t min after administration of the medications.

Correct Answer is C

Explanation

A) Mix the 2 medications together prior to administration: It is not recommended to mix medications together before administering them through an NG tube unless specifically instructed by a healthcare provider or the pharmacy. Some medications can interact or precipitate when combined, which could reduce their effectiveness or cause harmful reactions. Therefore, it is safer to administer each medication separately, followed by a flush.

B) Add the medications to a small amount of the formula: Medications should not be mixed with enteral feeding formula, as it can affect the absorption of the medication and alter its effectiveness. Additionally, the medications could interact with components of the formula, leading to complications or reduced efficacy.

C) Flush the tube with at least 30 mL of sterile water prior to administering the medications: This is the correct action. Flushing the NG tube with 30 mL of sterile water before administering medications helps ensure the tube is clear and patent, preventing clogging. It also prepares the tube to receive the medications, ensuring proper delivery into the gastrointestinal tract.

D) Connect the NG tube to suction 10 minutes after administration of the medications: Connecting the NG tube to suction immediately after medication administration could remove the medications before they are absorbed. It is important to wait at least 30 minutes after administering medications before connecting the NG tube to suction to ensure the medication is absorbed adequately.

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A nurse is reinforcing teaching about disease management with client who has GERD. Which of the following statements should the nurse make?

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Correct Answer is C

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