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?

Gastroesophageal reflux disease (GERD) is a condition characterized by the backflow of stomach acid into the esophagus, causing symptoms such as heartburn. Orange juice is highly acidic, and consuming acidic foods and beverages can exacerbate the symptoms of GERD. The acidic nature of orange juice can irritate the esophagus and contribute to increased acid reflux, leading to heartburn.

Sleeping on a large wedge-style pillow can actually help alleviate symptoms of GERD by elevating the head and upper body, reducing the likelihood of acid reflux during sleep.

Eating dinner early in the evening is generally recommended for individuals with GERD as it allows sufficient time for digestion before lying down. This can help prevent acid reflux during sleep.

Consuming low-fat meats is also a favorable choice for individuals with GERD as fatty foods can relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus. However, the options provided do not include any fatty foods, so it is not the primary contributing factor to the client's heartburn in this case.

Hydrochlorothiazide is a thiazide diuretic commonly used to treat hypertension and edema. One of the potential side effects of hydrochlorothiazide is hypokalemia (low potassium levels). To help counteract this effect, it is important for the client to increase their daily intake of foods high in potassium, such as bananas, oranges, spinach, avocados, and potatoes. This helps maintain adequate potassium levels in the body.

The other options mentioned are incorrect:

Take the medication on an empty stomach: Hydrochlorothiazide can be taken with or without food. It does not need to be taken on an empty stomach.

Muscle weakness is an expected adverse effect: Muscle weakness is not a common or expected adverse effect of hydrochlorothiazide. If the client experiences muscle weakness, they should notify their healthcare provider.

Take the medication at bedtime: Hydrochlorothiazide can be taken at any time of the day. There is no specific requirement to take it at bedtime. The dosing schedule should be determined based on the individual's needs and healthcare provider's instructions.