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?

To prepare a sterile field for the insertion of a urinary catheter, the nurse should follow the sequence of actions in the following order:

1. Perform hand hygiene.

2. Place the sterile package on the work surface.

3. Open the outermost flap of the package away from the body.

4. Open the side flaps of the package.

5. Open the innermost flap of the package toward the body.

6. Use the inner surface of the package as a sterile field.

Following this sequence ensures that the nurse maintains proper hand hygiene, prepares the sterile package, and opens it in a way that maintains sterility. Opening the flaps in the correct order helps create a sterile field within the package, which can be used for the insertion of the urinary catheter.

Sucralfate is a medication commonly used in the treatment of peptic ulcer disease. It works by forming a protective barrier over the ulcer site, providing a physical barrier against gastric acid, and promoting the healing process. When teaching a client about sucralfate, it is important to provide instructions regarding its proper administration.

One of the key instructions is to take sucralfate 1 hour before meals. This timing allows the medication to form a protective coating in the stomach before food is ingested. Taking sucralfate on an empty stomach enhances its effectiveness in protecting the ulcer and promoting healing.

"Take the medication with an antacid" - Sucralfate should not be taken with an antacid. Antacids can interfere with the protective mechanism of sucralfate by neutralizing stomach acid, which is necessary for sucralfate to bind and form a protective coating. It is recommended to wait at least 30 minutes to 1 hour after taking sucralfate before taking an antacid.

"Take as needed for pain relief" - Sucralfate is not typically used for immediate pain relief in peptic ulcer disease. It is primarily used for its protective and healing properties. Pain relief is

usually addressed with other medications, such as antacids, acid-reducing medications, or pain medications as prescribed by a healthcare provider.

"Store the medication in the refrigerator" - Sucralfate does not require refrigeration. It should be stored at room temperature, away from excessive heat or moisture, as per the specific instructions provided by the manufacturer or healthcare provider.