The student nurses ask the RN if a Foley catheter would be an appropriate intervention to protect intact skin for a patient who is not ambulatory, incontinent, and confused.
The nurse knows that it would be appropriate to ask the physician for an order to place a Foley catheter for this patient.

Choice A rationale

Chewing gum can increase salivary production, and while saliva may neutralize some stomach acid, the act of chewing can stimulate swallowing and possibly exacerbate symptoms by introducing excess air into the stomach. For GERD patients, avoiding gum may help reduce bloating and gas discomfort.

Choice B rationale

Elevating the head of the bed reduces the likelihood of acid reflux during sleep by using gravity to prevent stomach contents from flowing backward into the esophagus. This strategy aligns with GERD management guidelines and reduces nighttime symptoms.

Choice C rationale

Taking antacids between meals and at bedtime helps neutralize stomach acid temporarily, providing short-term relief of GERD symptoms. While effective, long-term use without addressing dietary and lifestyle factors is not ideal for managing GERD.

Choice D rationale

Eating small meals is beneficial for GERD, as it prevents overdistension of the stomach, but having a bedtime snack contradicts GERD management principles. Late-night eating may increase the risk of acid reflux when lying down, thus requiring more teaching.

Choice A rationale

Incisions into the renal pelvis for stone removal describe open surgical methods, not ultrasonic lithotripsy. This invasive approach is reserved for cases where less invasive techniques fail or stones are inaccessible through standard methods. Lithotripsy avoids direct incisions, utilizing external energy for stone fragmentation.

Choice B rationale

Kidney incisions for stone removal align with nephrolithotomy procedures rather than ultrasonic lithotripsy. This alternative represents open surgical intervention, distinct from non-invasive lithotripsy technologies. Lithotripsy eliminates stones using sound waves or lasers, reducing surgical risks and recovery times.

Choice C rationale

Ultrasonic lithotripsy employs high-frequency sound waves to break stones into small fragments. This minimally invasive method allows natural passage through the urinary tract or facilitates removal via catheterization. It reduces complications compared to invasive surgeries and is highly effective for calculi management.

Choice D rationale

Laser fragmentation techniques differ from ultrasonic lithotripsy, involving concentrated light energy to break stones. While both are minimally invasive, ultrasonic methods utilize sound waves rather than light energy for disintegration. This technical distinction outlines lithotripsy's use of external sound waves for stone management.