A nurse is providing education to a client with GERD (gastroesophageal reflux disease). The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend?

Reintroducing foods that intensify symptoms one at a time

Promoting intake of food and fluids 1 to 2 hours before bedtime

Maintaining an upright position following meals

Increasing the amount of carbonated beverages

Answer and Explanation

The Correct Answer is C

Choice A reason: Reintroducing foods that intensify symptoms one at a time is not an intervention that the nurse would recommend for a client with GERD. Foods that can trigger or worsen GERD symptoms include spicy, acidic, fatty, or fried foods, chocolate, coffee, alcohol, mint, garlic, and onion. The nurse would advise the client to avoid or limit these foods, not to reintroduce them.

Choice B reason: Promoting intake of food and fluids 1 to 2 hours before bedtime is not an intervention that the nurse would recommend for a client with GERD. Eating or drinking close to bedtime can increase the risk of acid reflux, as the stomach contents can flow back into the esophagus when the client lies down. The nurse would suggest the client to have smaller and more frequent meals, and to avoid eating or drinking at least 3 hours before bedtime.

Choice C reason: Maintaining an upright position following meals is an intervention that the nurse would recommend for a client with GERD. Keeping an upright posture can help prevent or reduce acid reflux, as gravity can help keep the stomach contents in place. The nurse would encourage the client to avoid bending, stooping, or lying down for at least 2 hours after eating.

Choice D reason: Increasing the amount of carbonated beverages is not an intervention that the nurse would recommend for a client with GERD. Carbonated beverages can increase the production of gas and stomach acid, which can cause bloating, belching, and acid reflux. The nurse would advise the client to drink water or other non-carbonated fluids, and to avoid drinking through a straw or chewing gum, which can also introduce air into the stomach.

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Correct Answer is C

Explanation

Choice A reason: Constipation is not a priority finding for a client with peptic ulcer disease. It may be a side effect of some medications or a result of decreased fluid intake, but it does not indicate a serious complication.

Choice B reason: Dyspepsia is a common symptom of peptic ulcer disease, but it is not a priority finding. It refers to indigestion or discomfort in the upper abdomen, which may be relieved by antacids or other medications.

Choice C reason: Hematemesis is a priority finding for a client with peptic ulcer disease. It indicates bleeding from the ulcer, which can lead to shock and anemia. The nurse should monitor the client's vital signs, hemoglobin level, and blood loss, and notify the provider immediately.

Choice D reason: Epigastric discomfort is another common symptom of peptic ulcer disease, but it is not a priority finding. It refers to pain or burning in the upper abdomen, which may be worsened by food intake or stress. The nurse should provide comfort measures and educate the client on dietary and lifestyle modifications.

A. Half-normal saline solution B. 10% dextrose in water C. 5% dextrose and half-normal saline solution D. Lactated Ringer's solution

Correct Answer is D

Explanation

Choice A reason: Half-normal saline solution is a hypotonic solution, which means it has a lower concentration of solutes than the blood plasma. It can cause fluid to shift from the blood vessels into the cells, leading to cellular swelling and edema.

Choice B reason: 10% dextrose in water is a hypertonic solution, which means it has a higher concentration of solutes than the blood plasma. It can cause fluid to shift from the cells into the blood vessels, leading to cellular shrinkage and dehydration.

Choice C reason: 5% dextrose and half-normal saline solution is a hypertonic solution, which has the same effects as choice B. The dextrose increases the osmolarity of the solution, while the half-normal saline provides some electrolytes.

Choice D reason: Lactated Ringer's solution is an isotonic solution, which means it has the same concentration of solutes as the blood plasma. It maintains fluid balance and provides electrolytes such as sodium, potassium, calcium, and lactate. It is commonly used for fluid resuscitation, dehydration, and acidosis.

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A nurse is providing education to a client with GERD (gastroesophageal reflux disease). The client asks what measures can be taken independently to help reduce the symptoms. Which interventions would the nurse recommend?

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