A nurse is reinforcing teaching with a client who is taking enoxaparin. Which of the following statements by the client indicates an understanding of the teaching?

Choice A Reason:

“Twill increase vitamin C intake by drinking orange juice." Reason why it might not indicate an understanding: Citrus juices like orange juice can exacerbate GERD symptoms due to their acidity. Increasing intake might worsen reflux symptoms for many individuals with GERD.

Choice B Reason:

“Will eat six small meals each day." This statement indicates an understanding. Eating smaller, more frequent meals instead of three large meals can help reduce pressure on the lower esophageal sphincter (LES), minimizing the likelihood of stomach contents flowing back into the esophagus, which commonly triggers GERD symptoms.

Choice C Reason:

"I will lie down for 30 minutes after each meal." Reason why it might not indicate an understanding: Lying down after meals can worsen GERD symptoms. Remaining upright or at least sitting upright for a few hours after meals helps prevent reflux by allowing gravity to assist in keeping stomach contents from moving up into the esophagus.

Choice D Reason:

“Will sleep flat on my back at night." Reason why it might not indicate an understanding: Sleeping flat on the back can aggravate GERD symptoms as it allows stomach acid to flow more easily into the esophagus. Sleeping with the head elevated (using pillows or an adjustable bed) is recommended to reduce nighttime reflux.

Choice A Reason:
Chill the dialysate prior to infusion. Generally, the dialysate used in peritoneal dialysis is warmed to body temperature before infusion to enhance comfort and prevent abdominal discomfort. Chilling the dialysate can cause discomfort and is not a standard practice in peritoneal dialysis.
Choice B Reason:
Monitor the client for diarrhea. While gastrointestinal symptoms might occur in some individuals undergoing peritoneal dialysis due to changes in fluid balance, diarrhea is not a typical or expected outcome. However, monitoring for any unusual gastrointestinal symptoms or changes in bowel habits is part of holistic client care.
Choice C Reason:
Weigh the client before and after the treatment. Weighing the client before and after peritoneal dialysis is a critical step to assess the effectiveness of the treatment. The difference in weight helps determine how much fluid was removed during the dialysis process, providing valuable information about the treatment's efficacy and the client's fluid status.
Choice D Reason:
Use clean gloves when handling dialysate bags. Maintaining aseptic technique during peritoneal dialysis is crucial to prevent infections. The use of clean gloves (not sterile gloves, unless otherwise specified) when handling dialysate bags helps minimize the risk of contamination, ensuring the safety of the procedure.