A nurse is teaching a client who is at 20 weeks of gestation about how to manage heartburn. Which of the following instructions should the nurse include?

A. "Eat a high-fat snack at bedtime": Consuming high-fat foods, especially close to bedtime, can exacerbate heartburn symptoms. Fatty foods delay gastric emptying and can contribute to increased acid production, leading to heartburn. Therefore, advising the client to avoid high-fat snacks before bedtime is essential for managing heartburn.
B. "Sip carbonated beverages throughout the day": Carbonated beverages, including soda and sparkling water, can exacerbate heartburn symptoms due to their acidic nature and carbonation. Therefore, advising the client to avoid or limit carbonated beverages is essential for managing heartburn.
C. "Drink hot herbal tea to relieve symptoms": Herbal teas such as chamomile or ginger tea can help alleviate heartburn symptoms by promoting digestion and soothing the gastrointestinal tract. Warm beverages can have a soothing effect on the esophagus and stomach, potentially providing relief from heartburn discomfort. Therefore, advising the client to drink hot herbal tea to relieve symptoms is an appropriate recommendation.
D. "Lie down for 30 min after meals": Remaining upright for at least 30 minutes after meals can help prevent acid reflux and reduce the risk of heartburn. However, lying down immediately after eating can worsen heartburn symptoms by allowing stomach acid to flow back into the esophagus. Therefore, advising the client to lie down for 30 minutes after meals is not an appropriate instruction for managing heartburn.

A. The client reports that the restraints are too tight: This indicates a need for adjustment of the restraints but does not necessarily indicate that the restraints should be discontinued altogether. The client's ability to follow commands and behave safely is a more critical factor in deciding whether to discontinue the restraints.
B. The client has been in the restraints for 4 hours: While prolonged use of restraints should be avoided due to the risk of complications such as skin breakdown and loss of mobility, the duration alone may not be the sole indicator for discontinuing restraints. The client's behavior and ability to follow commands are more important considerations.
C. The client is able to calmly follow commands: This is the most appropriate finding indicating that the restraints should be discontinued. Calmly following commands suggests that the client's behavior has improved and they are no longer a danger to themselves or others, making the restraints unnecessary.
D. The client can explain the reasons for their behavior: While understanding the reasons for the client's behavior is important for addressing underlying issues, it does not necessarily indicate that the client is no longer a risk to themselves or others. The ability to calmly follow commands is a more immediate concern when deciding whether to discontinue restraints.