Question

The nurse is reinforcing discharge teaching to a client diagnosed with GERD. Which statement by the client indicates a need for further instruction? A. "I should limit food intake to three large meals per day." B. "I need to remain upright for one to two hours after meals." C. "Since I am overweight, I need to follow a weight reduction diet." D. "I should avoid wearing tight-fitting clothes."

Short answer

Answer: A. "I should limit food intake to three large meals per day."

Step-by-step solution

Answer A

"I should limit food intake to three large meals per day." This statement indicates a need for further instruction because it is not a correct approach to managing GERD. Smaller, more frequent meals can help decrease acid reflux symptoms.

Answer B

"I need to remain upright for one to two hours after meals." This statement is correct because it helps prevent the stomach contents from flowing back into the esophagus, causing symptoms of GERD.

Answer C

"Since I am overweight, I need to follow a weight reduction diet." This statement is correct because excess weight can put pressure on the stomach and contribute to GERD symptoms. Losing weight may help lessen the symptoms of GERD.

Answer D

"I should avoid wearing tight-fitting clothes." This statement is also correct because tight-fitting clothes can put pressure on the stomach and make GERD symptoms more likely to occur. #placing emphasis on critical parts of the problem and solving it with the given exercise form#

Incorrect Statement

Based on the analysis of each statement, the incorrect statement that indicates a need for further instruction is Answer A, which advises limiting food intake to three large meals per day. This advice is incorrect for a client diagnosed with GERD and should be changed to recommend smaller, more frequent meals to avoid aggravating GERD symptoms.

Key concepts

Nursing Discharge Teaching

Effective nursing discharge teaching is essential for patients managing chronic conditions like Gastroesophageal Reflux Disease (GERD). Nurses must equip patients with knowledge about the illness, its triggers, and ways to control symptoms through lifestyle adjustments and diet.

For instance, patients should understand the importance of meal structure—focusing on smaller, more frequent meals rather than three large ones—as larger meals can increase stomach pressure and worsen reflux symptoms. Education about proper posture after eating, avoiding tight clothing, and the potential benefits of weight loss are also components of discharge teaching. When reinforcing discharge instructions, nurses should ensure that patients clearly understand these recommendations and why they are necessary. It's also crucial to assess understanding through teach-back methods, where the patient repeats the instructions, revealing any areas needing further clarification.

Diet Modifications for GERD

When addressing diet modifications for GERD management, the patient’s eating habits are a primary point of focus. It's not just about what they eat, but how and when as well. Advising patients to opt for smaller, frequent meals helps prevent the stomach from becoming too full, thereby reducing pressure on the lower esophageal sphincter (LES), and minimizing reflux events.

Patients should also be informed about specific foods to avoid—such as spicy, fatty, or acidic items which can irritate the esophagus or cause the LES to relax, leading to reflux. Also, beverages like coffee, carbonated drinks, and alcohol may have to be limited, as they can exacerbate symptoms. Instead, patients can be directed towards GERD-friendly alternatives like lean meats, fibrous vegetables, and non-citrus fruits. Monitoring and possibly adjusting one's diet are proven strategies for reducing GERD-related discomfort.

Lifestyle Changes for GERD

In tandem with diet, lifestyle changes play a significant role in the successful management of GERD. Beyond eating patterns, patients are advised to maintain an upright position for one to two hours after eating to help prevent acid reflux—an action substantiated by the correct response from the patient in the exercise. Additionally, steering clear of tight-fitting garments can decrease abdominal pressure that might provoke GERD symptoms.

Other critical lifestyle adjustments include weight management for those who are overweight since excess abdominal fat can increase the frequency and severity of symptoms. Patients should be motivated to engage in regular, moderate exercise which supports overall health and weight loss efforts, without overly straining the abdominal area after meals. Nurses should also emphasize the importance of stress reduction, which can contribute to symptom flare-ups, guiding patients to explore relaxation techniques that can mitigate stress-induced acid reflux.