The nurse is assessing an elderly client who was diagnosed with GERD for complaints of heartburn at night that is so severe it causes insomnia. After some discussion they decide that the client will:
1. Avoid caffeine at bedtime and sleep with the head of his bed elevated. 2. Substitute a noncaffeinated diet soda before bed in place of tea. 3. Limit food seasonings to garlic, red pepper, and sea salt. 4. Continue hot tea at bedtime and sleep with the foot of his bed elevated.
1
Rationale: Avoiding caffeinated beverages and sleeping with the head of the bed elevated are recommended to decrease symptoms of GERD. Carbonated beverages, which can cause gastric distention, should also be avoided including those that are noncaffeinated. Spicy seasonings such as garlic and red pepper may cause irritation to the lower portion of the esophagus. Sleeping in a position that elevates the feet will increase symptoms and should be avoided.
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