A nurse is reinforcing teaching with a client who has a new ileostomy. Which of the following statements by the client indicates an understanding of the teaching?

Choice A Reason;
"You should consume small, frequent meals each day." This statement is advisable for COPD management. Eating smaller, more frequent meals can help prevent bloating or feeling overly full, which might interfere with breathing due to increased pressure on the diaphragm.
Choice B Reason:
"You should decrease your caloric intake by 200 calories per day." While maintaining a healthy weight is important for COPD management, reducing caloric intake without specific guidance or assessment might not be suitable. It's crucial to consult with a healthcare provider or dietitian for individualized dietary recommendations.
Choice C Reason:
"You should increase your oxygen to 5 liters per minute if you have shortness of breath." Adjusting oxygen flow should be done based on a healthcare provider's prescribed guidelines. Self-adjustment of oxygen flow without medical advice can be risky and might not address the underlying cause of shortness of breath during a COPD exacerbation.
Choice D Reason:
"You should discontinue your prednisone when your symptoms improve." Prednisone or other corticosteroids are often prescribed during a COPD exacerbation to reduce inflammation in the airways. However, discontinuing corticosteroids abruptly without a healthcare provider's guidance can lead to a recurrence of symptoms or potential complications. It's important to follow the prescribed regimen and complete the course as directed.

Choice A Reason:

“Twill increase vitamin C intake by drinking orange juice." Reason why it might not indicate an understanding: Citrus juices like orange juice can exacerbate GERD symptoms due to their acidity. Increasing intake might worsen reflux symptoms for many individuals with GERD.

Choice B Reason:

“Will eat six small meals each day." This statement indicates an understanding. Eating smaller, more frequent meals instead of three large meals can help reduce pressure on the lower esophageal sphincter (LES), minimizing the likelihood of stomach contents flowing back into the esophagus, which commonly triggers GERD symptoms.

Choice C Reason:

"I will lie down for 30 minutes after each meal." Reason why it might not indicate an understanding: Lying down after meals can worsen GERD symptoms. Remaining upright or at least sitting upright for a few hours after meals helps prevent reflux by allowing gravity to assist in keeping stomach contents from moving up into the esophagus.

Choice D Reason:

“Will sleep flat on my back at night." Reason why it might not indicate an understanding: Sleeping flat on the back can aggravate GERD symptoms as it allows stomach acid to flow more easily into the esophagus. Sleeping with the head elevated (using pillows or an adjustable bed) is recommended to reduce nighttime reflux.