A nurse is assisting with the care of a client following electroconvulsive therapy for the treatment of a depressive disorder, which of the following findings should the nurse expect 15 min following the procedure?

Rationale:

A. "You should eat three large meals and two snacks per day." Eating large meals increases gastric pressure and can worsen reflux symptoms by promoting the backflow of stomach acid into the esophagus. Clients with GERD are advised to consume smaller, more frequent meals to reduce gastric distention.

B. "You should elevate the head of the bed while sleeping." Elevating the head of the bed helps prevent nighttime reflux by using gravity to reduce the likelihood of stomach acid flowing back into the esophagus. This is a key non-pharmacologic strategy in managing GERD symptoms during sleep.

C. "You should only drink 2 cups of coffee per day." Coffee, regardless of the quantity, can relax the lower esophageal sphincter and stimulate acid production. Rather than limiting intake to two cups, clients with GERD are often advised to avoid coffee altogether or monitor symptoms closely.

D. "You should lay down for 1 hour following a meal." Lying down after eating increases the risk of acid reflux due to the horizontal position reducing the effect of gravity. Clients should remain upright for at least 2 to 3 hours after meals to minimize reflux episodes.

Rationale:

A. Withhold the medication until the provider signs the prescription: Waiting for the provider's signature before administering a telephone order may delay critical care. Verbal or telephone orders can be acted upon immediately if clearly understood, documented, and later signed by the provider within the facility’s required timeframe.

B. Record the date and time of the telephone prescription: Accurate documentation includes noting the date and time the telephone order was received. This ensures clarity, legal compliance, and proper sequencing of medical events in the client's record.

C. Request that the provider confirm the read-back of the prescription: A read-back process reduces the risk of medication errors by confirming that the nurse correctly heard and understood the provider’s order. It is a Joint Commission-recommended safety practice.

D. Ask the provider to spell out the name of the medication: Asking the provider to spell out high-risk or sound-alike medications helps avoid transcription errors. This step is especially important when communication clarity is compromised over the phone.

E. Instruct another nurse to record the prescription in the medical record: The nurse receiving the order is responsible for documenting it. Delegating this task to another nurse increases the chance of miscommunication and errors, and violates proper protocol.