A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patient's symptoms? (Select all that apply.)
a. Avoiding hot, spicy foods
b. Avoiding tobacco products
c. Drinking a glass of red wine with dinner
d. Eating a snack before bedtime
e. Taking ibuprofen with food
f. Using a small pillow for sleeping
g. Wearing well-fitted clothing
ANS: A, B, E
Hot, spicy foods aggravate gastric upset, tobacco increases gastric secretions, and ibuprofen on an empty stomach increases gastric secretions, so patients should be taught to avoid these actions. Alcohol should be avoided since it increases gastric secretions. Eating at bedtime increases reflux, as does laying relatively flat to sleep, or wearing fitted clothing.
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