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 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.
Correct Answer is ["B","C","D","E"]
Explanation
A. Dietary restriction while taking hydrocodone
There are no specific dietary restrictions associated with hydrocodone use. This option is not relevant to hydrocodone therapy.
B. Instructions not to exceed recommended dosage
It is crucial to emphasize to the patient not to exceed the recommended dosage of hydrocodone. Exceeding the prescribed dose can lead to adverse effects, including respiratory depression.
C. Instructions not to use alcohol or CNS depressants while taking hydrocodone
Hydrocodone is a central nervous system (CNS) depressant. Combining it with alcohol or other CNS depressants can increase the risk of respiratory depression and sedation. Patients should be advised to avoid alcohol and other drugs that depress the CNS.
D. Instructions on how to prevent constipation
Opioid medications, including hydrocodone, can cause constipation. Patients should receive instructions on how to prevent constipation, such as increasing fluid and fiber intake and incorporating regular physical activity.
E. Side effects to report
Patients should be educated about potential side effects of hydrocodone and instructed to report any unusual or severe side effects to their healthcare provider promptly. This may include symptoms such as respiratory distress, severe drowsiness, or allergic reactions.
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