The nurse is instructing a patient recently diagnosed with GERD. Which statement by the patient indicates a need for further teaching?

A. Avoid caffeine-containing beverages before sleep

The highest priority teaching point to help relieve sleeplessness would be to advise the client to avoid caffeine-containing beverages before sleep. Caffeine is a stimulant that can interfere with the ability to fall asleep and maintain a restful sleep.

B. Perform strenuous exercise before bedtime

Strenuous exercise close to bedtime can actually stimulate the body and make it more difficult for the individual to relax and fall asleep. It is generally recommended to engage in exercise earlier in the day.

C. Drink lots of fluids before bedtime

Drinking excessive fluids before bedtime may lead to disrupted sleep as it can increase the need to wake up for bathroom trips during the night. It's advisable to limit fluid intake close to bedtime.

D. Eat a heavy meal before bedtime

Consuming a heavy meal before bedtime can cause discomfort and indigestion, potentially disrupting sleep. It is recommended to have a light, easily digestible meal if eating close to bedtime.

A. The importance of consuming adequate amounts of water

When instructing a patient who will take psyllium (Metamucil) to treat constipation, it is crucial to emphasize the importance of consuming adequate amounts of water. Psyllium is a bulk-forming laxative that works by absorbing water in the intestines, forming a gel-like mass that helps soften stools and promote bowel movements. Without sufficient water intake, psyllium may cause an obstruction or worsen constipation.

B. The need to monitor for systemic side effects.

Psyllium is generally well-tolerated and is not associated with significant systemic side effects. The primary consideration is ensuring proper hydration.

C. The onset of action of 30-60 minutes after administration.

Psyllium is not a fast-acting laxative. It usually takes a longer time to produce its effects, and patients should not expect an immediate response within 30-60 minutes.

D. The need to use the dry form of psyllium to prevent cramping.

Using the dry form of psyllium is not recommended, as it may increase the risk of choking or swallowing difficulties. It is typically recommended to mix psyllium with a sufficient amount of water or other liquids to prevent cramping and ensure proper absorption.