After several months of persistent heartburn, a 57-year-old female client has been diagnosed with gastroesophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman’s health problem?

Choice A reason: Insufficient mast cell numbers are not a primary cause of impaired healing in older adults. Mast cells contribute to inflammation, but chronic diseases like diabetes disrupt multiple healing pathways more significantly, making this incorrect.

Choice B reason: Circulatory impairment, such as atherosclerosis, can delay healing by limiting oxygen and nutrient delivery. However, it’s often a consequence of chronic illnesses like diabetes, which broadly affect healing, making this less primary than chronic conditions.

Choice C reason: Underlying chronic illnesses, like diabetes or cardiovascular disease, impair inflammation and wound healing in older adults by disrupting immune function, collagen deposition, and perfusion. These prevalent conditions directly impact healing, making this the correct cause.

Choice D reason: Complement and chemotaxis deficiencies occur in specific immunodeficiencies, not commonly in aging. Chronic illnesses like diabetes more consistently impair healing through systemic effects, making this a less likely primary cause.

Choice A reason: Redness and heat are local inflammatory signs, occurring at the injury site due to vasodilation. Systemic manifestations, like fever and leukocytosis, affect the whole body, reflecting immune activation, so this is incorrect for systemic inflammation.

Choice B reason: Fever and leukocytosis are systemic manifestations of inflammation, involving the entire body. Fever results from cytokine release, and leukocytosis indicates increased white blood cells, both reflecting widespread immune response, making this the correct choice for systemic effects.

Choice C reason: Pain and edema are primarily local inflammatory responses, occurring at the site of injury or infection. Systemic effects, like fever and leukocytosis, involve broader physiological changes, so this is incorrect for systemic inflammation manifestations.

Choice D reason: Formation of exudates is a local inflammatory response, involving fluid leakage at the injury site. Systemic manifestations, such as fever and leukocytosis, affect the whole body, so this is incorrect for the systemic category of inflammation.