A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patient's symptoms? (Select all that apply.)
Avoiding hot, spicy foods
Avoiding tobacco products
Drinking a glass of red wine with dinner
Eating a snack before bedtime
Using a small pillow for sleeping
Correct Answer : A,B,E
A. Avoiding hot, spicy foods
Spicy foods can increase the production of stomach acid and may irritate the esophagus, worsening GERD symptoms. Avoiding hot and spicy foods is a dietary measure to minimize the risk of symptom exacerbation.
B. Avoiding tobacco products
Tobacco use is a known risk factor for GERD. Smoking can relax the lower esophageal sphincter (LES), allowing stomach acid to flow back into the esophagus. Advising the patient to quit or avoid tobacco products can contribute to symptom management.
C. Drinking a glass of red wine with dinner
While red wine may have some potential benefits, alcohol, in general, can relax the LES, leading to increased reflux. Therefore, drinking red wine with dinner may not be recommended for someone experiencing GERD symptoms.
D. Eating a snack before bedtime
Eating close to bedtime can increase the likelihood of GERD symptoms, as lying down may allow stomach acid to flow back into the esophagus. The nurse may advise against eating a snack right before bedtime to minimize nighttime reflux.
E. Using a small pillow for sleeping
Elevating the head and upper body during sleep can help prevent stomach acid from flowing into the esophagus. Using a small pillow for sleeping is a measure to reduce nighttime reflux and alleviate GERD symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Continue taking OCPS because phenytoin is not safe during pregnancy."
This statement is not accurate. While it's essential to address pregnancy risk, phenytoin can reduce the effectiveness of oral contraceptives. Women on phenytoin are often advised to use additional contraceptive measures.
B. "You should use a backup method of contraception along with OCPs."
This is the correct response. Phenytoin can accelerate the metabolism of oral contraceptives, potentially reducing their effectiveness. Using a backup method, such as condoms, is recommended to ensure adequate contraception.
C. "You should stop taking OCPs because of drug-drug interactions with phenytoin."
This advice is generally not recommended without consulting the healthcare provider. Abruptly stopping OCPs without an alternative form of contraception can increase the risk of unintended pregnancy.
D. "You should take low-dose aspirin while taking these medications to reduce your risk of stroke."
This statement is not relevant to the situation described. Low-dose aspirin is not typically recommended for contraception, and its use in this context does not address the potential interaction between phenytoin and oral contraceptives.
Correct Answer is D
Explanation
A. Administer the dose since the patient is not toxic.
This is not the appropriate action. With a drowsy patient and a high serum phenytoin level, there is a concern for toxicity. Administering the next dose could worsen the toxicity.
B. Contact the provider to discuss decreasing the phenytoin dose.
While adjusting the dose may be a consideration, the immediate action should be to withhold the next dose and report the elevated level to the healthcare provider. The provider can then determine the appropriate course of action.
C. Give the drug and monitor closely for adverse effects.
Giving the drug without further intervention is not appropriate when there are signs of potential toxicity, such as drowsiness. Monitoring alone is not sufficient in this case.
D. Report drug toxicity to the providers.
This is the correct choice. With a drowsy patient and a serum phenytoin level of 18 mcg/mL, which is considered high, reporting the drug toxicity to the healthcare provider is the immediate and appropriate action. The provider can then determine the next steps, such as adjusting the dose or ordering additional tests.
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