A nurse is providing teaching for a client diagnosed with gastroesophageal reflux disease (GERD) about ways to manage the condition. Which of the following instructions should the nurse include?

A. Dyspepsia:

Dyspepsia refers to discomfort or pain in the upper abdomen, often described as indigestion. It is a common symptom of peptic ulcer disease but is not as urgent as the manifestation described in option C.

B. Epigastric discomfort:

Epigastric discomfort is a common symptom of peptic ulcer disease, but the priority is to identify more severe complications, such as bleeding.

C. Hematemesis:

This is the correct answer. Hematemesis refers to the vomiting of blood, which is a serious and potentially life-threatening complication of peptic ulcer disease. It indicates active bleeding in the upper gastrointestinal tract and requires prompt medical attention.

D. Epigastric pain:

Epigastric pain is similar to epigastric discomfort and is a common symptom of peptic ulcer disease. However, the priority in the given options is to identify the more severe complication of hematemesis.

A. Warfarin:

Warfarin is an anticoagulant that works by inhibiting the synthesis of certain clotting factors, including factors II, VII, IX, and X. While it is used to prevent thromboembolic events, in a client with cirrhosis and an elevated PT, the priority is addressing the coagulation factor deficiency rather than adding an anticoagulant.

B. Vitamin K:

Vitamin K is the antidote for warfarin, and it helps in the synthesis of clotting factors. In cirrhosis, there can be impaired synthesis of clotting factors due to liver dysfunction. Administering vitamin K can aid in correcting coagulation abnormalities.

C. Heparin:

Heparin is another anticoagulant, but it does not reverse the effects of warfarin. It works by a different mechanism and is typically used in acute settings, such as deep vein thrombosis or pulmonary embolism. It is not the primary intervention for an elevated PT in cirrhosis.

D. Ferrous sulfate:

Ferrous sulfate is an iron supplement and is not indicated for the correction of an elevated PT. Iron supplements are typically used to address iron deficiency anemia.