The nurse is caring for a client with a new diagnosis of asthma. Which teaching point should the nurse emphasize for proper inhaler use?

Choice A reason: Frequent small meals reduce gastroesophageal reflux by minimizing gastric distension, which decreases pressure on the lower esophageal sphincter. This prevents acid reflux into the esophagus, alleviating heartburn and irritation, making it an effective dietary strategy for managing GERD symptoms.

Choice B reason: Switching to decaffeinated coffee and tea may reduce reflux triggers, as caffeine relaxes the lower esophageal sphincter. However, small meals are more effective, as they directly reduce gastric volume and sphincter pressure, providing broader symptom relief than caffeine avoidance alone.

Choice C reason: Avoiding milk and cream is relevant for some GERD patients, as high-fat foods delay gastric emptying, increasing reflux. However, frequent small meals address the root cause of reflux by reducing gastric pressure, making this a more universally effective strategy than specific food avoidance.

Choice D reason: Listing high-dairy snack foods reinforces avoidance but is less direct than recommending small meals. Dairy may trigger reflux in some, but frequent small meals broadly reduce gastric distension and sphincter pressure, offering a more immediate and effective GERD management strategy.

Choice A reason: Limiting potassium-rich foods is critical in chronic kidney disease, as impaired renal excretion causes hyperkalemia, risking cardiac arrhythmias. Foods like bananas and oranges are restricted to maintain safe potassium levels, making this the priority dietary teaching to prevent life-threatening complications.

Choice B reason: Increasing protein intake is inappropriate, as chronic kidney disease requires protein restriction to reduce uremic toxins and kidney workload. Potassium restriction is prioritized, as hyperkalemia poses an immediate cardiac risk, making it the essential dietary focus over protein adjustments.

Choice C reason: Restricting carbohydrates is not standard in chronic kidney disease unless diabetes is present. Potassium restriction is critical, as elevated potassium levels from impaired renal clearance cause arrhythmias, making it the priority dietary intervention to ensure cardiac safety.

Choice D reason: Encouraging high-sodium foods is incorrect, as sodium restriction prevents fluid retention and hypertension in chronic kidney disease. Potassium restriction is the priority, as hyperkalemia directly threatens cardiac function, making it the essential dietary focus over sodium concerns.