A nurse is collecting data from a client who has gastroesophageal reflux disease (GERD) and reports having heartburn every night. Which of the following actions should the nurse identify as a contributing factor to the client's heartburn?

Peptic ulcer disease is characterized by open sores that develop on the lining of the stomach, small intestine, or esophagus. The symptoms and pain associated with peptic ulcer disease can

vary, but certain patterns are commonly observed: "The pain is worse after I eat a meal high in fat": This statement aligns with the typical symptom of peptic ulcer disease. The presence of fat in the stomach triggers the release of certain hormones and substances that stimulate gastric acid secretion. This increased acid production can exacerbate the pain experienced by individuals with peptic ulcers.

"I feel so much better after eating": Feeling relief after eating is not characteristic of peptic ulcer disease. In fact, individuals with peptic ulcers may experience pain or discomfort after eating especially those with gastric ulcers.

"The pain radiates down to my lower back": Lower back pain is not a common symptom associated specifically with peptic ulcer disease. Radiating pain to the back is more commonly associated with conditions like pancreatitis or kidney issues.

"My pain is relieved by having a bowel movement": Pain relief with bowel movements is not a typical symptom of peptic ulcer disease. It may be more indicative of conditions like irritable bowel syndrome or inflammatory bowel disease.

Atenolol is a beta-blocker medication commonly used to treat conditions such as hypertension (high blood pressure) and certain heart rhythm disorders. One of the intended effects of atenolol is to lower the heart rate by blocking the action of adrenaline on beta receptors in the heart. However, this can sometimes result in bradycardia, which refers to a heart rate that is slower than the normal range.

Hypokalemia, or low potassium levels, is not directly caused by atenolol but can be an indirect effect. Beta-blockers like atenolol can potentially interfere with the normal release of insulin and contribute to increased urinary excretion of potassium. Therefore, it's important to monitor potassium levels in clients taking atenolol, as low potassium levels can have adverse effects on various body systems.

Anemia and neutropenia are not typically associated with the use of atenolol. Anemia refers to a decrease in the number of red blood cells or a decrease in the amount of hemoglobin, which carries oxygen to the body tissues. Neutropenia refers to a decrease in the number of neutrophils, which are a type of white blood cell involved in fighting infection.