The nurse is providing discharge teaching for the client newly diagnosed with GERD. The teaching should Include Instructions to: (SELECT ALL THAT APPLY)
eat small frequent meals during the day.
enroll in smoking cessation classes as needed.
take omeprazole 30 minutes after meals when acid levels are highest.
elevate the head of the bed at night.
eat your largest meal at bedtime.
Correct Answer : A,B,D
A. Eating smaller, more frequent meals can help reduce the likelihood of gastric distention and decrease the pressure on the lower esophageal sphincter (LES), which can help reduce reflux symptoms.
B. Smoking is a risk factor for GERD as it can weaken the LES and increase acid reflux. Therefore, quitting smoking can help alleviate symptoms and improve overall health.
D. Elevating the head of the bed by 6 to 8 inches can help reduce nighttime reflux symptoms by using gravity to prevent stomach acid from flowing back into the esophagus.
C. Proton pump inhibitors (PPIs) like omeprazole are typically taken before meals to inhibit acid production and prevent reflux symptoms. Taking omeprazole after meals may not provide optimal acid suppression when it is most needed.
E. Eating a large meal right before bedtime can increase the likelihood of reflux symptoms as lying down after eating can worsen reflux. It is recommended to avoid large meals, particularly before bedtime, to minimize GERD symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Teach the client to support the surgical site while deep breathing and coughing: This action is appropriate as it helps prevent complications such as atelectasis and pneumonia by promoting lung expansion and clearing secretions. Supporting the surgical site while deep breathing and coughing helps reduce pain and discomfort during these activities.
B. This is an important teaching point for clients using PCA for pain control after surgery. Opioid medications used in PCA can lead to gastrointestinal motility issues, including constipation. However, pain management is central within the first 24 hours post operation.
C. Irrigating and repositioning the NGT frequently can increase the risk of complications such as displacement or irritation of the surgical site. NGT care should be performed as needed based on institutional protocols and the client's condition.
D. The client's diet will likely be advanced gradually, starting with clear fluids and progressing to full liquids and then solid foods as tolerated. Fruit juices may be introduced gradually as part of the liquid diet once the client's gastrointestinal function has recovered sufficiently.
Correct Answer is B
Explanation
B. Bariatric surgery, such as gastric bypass or sleeve gastrectomy, is considered the most effective intervention for sustained weight loss in the extremely obese population. Bariatric surgery leads to significant weight loss and improvement in obesity-related comorbidities such as type 2 diabetes, hypertension, and obstructive sleep apnea.
A. Medications may help in conjunction with lifestyle modifications such as diet and exercise, but they are not typically the primary intervention for sustained weight loss in extremely obese individuals.
C. While dietary modifications are essential for weight loss and management, traditional dieting alone may not provide the most sustained weight loss in the extremely obese population.
D. Regular physical activity is important for overall health and can contribute to weight loss and weight maintenance. However, an exercise program alone may not provide the most sustained weight loss in the extremely obese population, especially without accompanying dietary modifications.
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