A nurse is teaching a client who has a prescription of a nasogastric tube (NG) to treat a pyloric obstruction. Which of the following rationales for the use of the nasogastric tube should the nurse include in the teaching?

A. Is used to replace fluid loss.

Isotonic solutions, such as normal saline (0.9% NaCl) and lactated Ringer's solution, are used to replace fluid loss in situations such as dehydration, surgery, trauma, or other conditions where there is a need for fluid resuscitation.

B. Usually do not provide calories.

Isotonic solutions typically do not contain calories. They are designed primarily for fluid replacement and do not contribute to the nutritional needs of the patient.

C. Does not expand intravascular volume.

This statement is incorrect. Isotonic solutions are used to expand intravascular volume. When infused into the bloodstream, isotonic solutions help restore and maintain adequate blood volume. They do not cause significant shifts of fluids between compartments.

D. Mostly do not provide free water.

Isotonic solutions generally do not provide free water. They have the same osmolality as body fluids, meaning that they do not cause a net movement of water into or out of cells, and they maintain the osmotic balance.

E. Has the same osmolality as body fluids.

Isotonic solutions have the same osmolality as body fluids, which means they do not cause a net movement of water into or out of cells. This characteristic makes them suitable for situations where there is a need to expand intravascular volume without causing significant shifts in fluid compartments.

A. "Eat four small meals each day":

Smaller, more frequent meals reduce gastric distension and lower gastric pressure, which decreases reflux of stomach contents into the esophagus. Large meals increase intra-abdominal pressure and worsen GERD symptoms.

B. "Sleep on your left side":

Sleeping on the left side may reduce symptoms of GERD for some individuals. This position can keep the stomach below the esophagus, minimizing reflux. However, individual preferences and comfort should be considered.

C. "Wait to go to bed for 1 hour after eating":

This instruction helps reduce the risk of reflux while lying down. Waiting after eating allows gravity to aid in digestion and reduces the likelihood of stomach contents backing up into the esophagus during sleep.

D. "Drink milk to soothe your stomach":

While milk might provide temporary relief for some people by neutralizing stomach acid, it can stimulate acid production, potentially exacerbating GERD symptoms in the long run. Therefore, it's not a recommended solution for managing GERD.