A nurse is teaching a client about strategies to manage gastroesophageal reflux disease (GERD). Which of the following statements should the nurse include?
"Avoid snacking between meals.”.
"Limit foods that are high in fiber.”.
"Elevate the head of your bed by 18 inches.”.
"Avoid eating 2 to 3 hours before bedtime.”. . . .
The Correct Answer is D
Choice A rationale
Avoiding snacking between meals can actually worsen GERD symptoms for some individuals by allowing the stomach to become completely empty, which can then lead to increased acid production when the next meal is consumed. Smaller, more frequent meals are often recommended to maintain a more consistent level of gastric contents and reduce acid reflux.
Choice B rationale
Limiting foods high in fiber is generally not recommended for managing GERD. Fiber helps with gastric emptying and can prevent constipation, which can indirectly increase intra-abdominal pressure and potentially worsen reflux. A balanced diet with adequate fiber is usually encouraged.
Choice C rationale
Elevating the head of the bed by 6 to 8 inches, not 18 inches, is a recommended strategy to manage GERD. Gravity helps to keep stomach acid down in the stomach. An elevation of 18 inches might be too steep and uncomfortable for sleeping, potentially leading to other issues.
Choice D rationale
Avoiding eating 2 to 3 hours before bedtime is a crucial recommendation for managing GERD. Lying down shortly after eating can facilitate the backflow of stomach acid into the esophagus because gravity no longer assists in keeping the acid in the stomach. Allowing time for some gastric emptying before lying down can significantly reduce nighttime reflux symptoms. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Glaucoma is characterized by damage to the optic nerve, often due to increased intraocular pressure. Without proper management to lower this pressure, the damage to the optic nerve progresses, leading to irreversible vision loss and eventually blindness.
Choice B rationale
The primary goal of glaucoma treatment with eye drops is to lower intraocular pressure and prevent further damage to the optic nerve, thereby preserving existing vision. Eye drops do not typically improve vision that has already been lost due to glaucoma.
Choice C rationale
Glaucoma is usually associated with impaired drainage or overproduction of aqueous humor, leading to increased intraocular pressure, not inadequate production of fluid. This elevated pressure is the primary risk factor for optic nerve damage.
Choice D rationale
Double vision (diplopia) is not a common or characteristic symptom of glaucoma. While various eye conditions can cause double vision, glaucoma primarily affects peripheral vision and visual acuity without causing diplopia. .
Correct Answer is D
Explanation
Choice A rationale
Milk can temporarily buffer stomach acid, but it also stimulates acid production due to its fat and calcium content, potentially worsening GERD symptoms in the long run. Therefore, this is not a recommended instruction for managing GERD.
Choice B rationale
Sleeping on the left side may help reduce nighttime reflux in some individuals because the esophagus enters the stomach on the right side. This positioning can keep the lower esophageal sphincter above the level of gastric contents, reducing the likelihood of reflux.
Choice C rationale
Lying down shortly after eating can increase the risk of stomach acid refluxing into the esophagus. Gravity helps to keep stomach contents down when a person is upright. Waiting at least 2 to 3 hours after eating before going to bed is generally recommended to manage GERD.
Choice D rationale
Eating larger meals can increase gastric pressure and the volume of stomach contents, both of which can contribute to reflux. Consuming four to six smaller meals throughout the day can help reduce gastric distension and acid production after meals, thereby minimizing GERD symptoms.
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