Which instructions should the nurse provide for a patient diagnosed with gastroesophageal reflux disease (GERD)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply
1. Limit last food intake to 4 hours before bedtime.
2. Eat the largest meal of the day at midday.
3. Sleep in a bed with the head elevated 6 to 8 inches.
4. Follow a daily exercise routine.
5. Include a caffeinated beverage with meals.
1,2,3,4
Rationale 1: The patient should avoid eating anything within 4 hours of bedtime.
Rationale 2: It is often helpful to eat small, frequent meals, with the largest meal at midday.
Rationale 3: The head of the bed should be elevated.
Rationale 4: A regular exercise program such as daily walking can promote digestion.
Rationale 5: Caffeine has been shown to lower LES pressure and so should be avoided.
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