Select words from the choices below to fill in each blank in the following sentence.

To further evaluate the client, the nurse anticipates the client will need

____

and

____

.

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.

A) Initiate droplet precautions: Respiratory syncytial virus (RSV) is primarily spread through contact with respiratory secretions, and droplet precautions are essential to prevent transmission. While RSV is commonly transmitted via direct contact or droplets, additional precautions like contact precautions may also be required, but droplet precautions should definitely be initiated as part of standard care to prevent the spread of the virus to others.

B) Monitor the preschooler’s urine for protein: Monitoring the urine for protein is not a standard action related to RSV. RSV is a respiratory virus, and its primary symptoms and complications involve the respiratory system, such as difficulty breathing, wheezing, or respiratory distress. There is no direct link between RSV and proteinuria, so this action is not necessary.

C) Administer fluconazole to the preschooler: Fluconazole is an antifungal medication, and it is not used to treat respiratory syncytial virus. RSV is a viral infection, so antiviral medications or supportive care like oxygen therapy, hydration, and possibly bronchodilators may be more appropriate. Fluconazole would not be appropriate for treating a viral infection like RSV.

D) Request an x-ray of the preschooler’s neck: An x-ray of the neck is generally not indicated for RSV unless there is a specific concern about airway obstruction or another condition like croup, which may present with symptoms similar to RSV. RSV primarily affects the lower respiratory tract, leading to symptoms like wheezing, cough, and difficulty breathing, not necessarily requiring a neck x-ray.