A nurse is discussing good food choices with a client who is recovering from an exacerbation of inflammatory bowel disease and is to start a low-lactose diet. Which of the following foods is the best choice for the client?

A. Positioning the head of the bed at 10 degrees is not sufficient for optimizing respiratory function. Typically, the head of the bed should be elevated to 30–45 degrees to help with breathing and reduce the risk of aspiration.
B. Encouraging fluid intake of 1500 mL/day may be too low for a client with pneumonia. Adequate hydration is important to thin mucus and help with expectoration, especially in the context of pneumonia. Typically, fluid intake should be higher unless contraindicated.
C. Coughing and deep breathing every 8 hours is insufficient. To prevent atelectasis and promote effective clearance of secretions in clients with pneumonia, coughing and deep breathing should be done more frequently, typically every 2 hours.
D. Obtaining a sputum culture is a priority for determining the specific pathogen causing the pneumonia and guiding antibiotic treatment. A sputum culture helps identify bacterial, viral, or fungal organisms that may be present, which is crucial for managing recurrent pneumonia, especially in an immunocompromised client with AIDS.

A. Maintaining a healthy weight is important in managing a hiatal hernia. Excess weight can increase abdominal pressure, which may worsen symptoms of acid reflux.
B. Sleeping with the head of the bed elevated helps prevent acid reflux and symptoms of heartburn associated with a hiatal hernia. Elevation reduces the risk of stomach contents moving into the esophagus during sleep.
C. Drinking less fluid is not a necessary dietary change for hiatal hernia management. However, clients should avoid consuming large amounts of fluid with meals, as this may exacerbate reflux symptoms.
D. Consuming less caffeine and fewer spicy foods is appropriate because both can irritate the esophagus and increase acid reflux. Caffeine and spicy foods are known to trigger symptoms in individuals with a hiatal hernia.
E. Lying down for one-half hour after meals is not recommended for clients with a hiatal hernia, as it can worsen symptoms of reflux. The client should be advised to wait at least 2–3 hours before lying down after eating.