Patho Patho #6
Which instructions should the nurse include when performing dietary teaching for a client with newly diagnosed gastroesophageal reflux disease (GERD)?
- Consume a diet with a moderate amount of fat.
This answer choice is not correct because clients with GERD should be taught to eat fewer foods that are high in fat. A bland diet is recommended for clients with GERD.
- Eat a high carbohydrate snack before bedtime.
This answer choice is not correct because clients with GERD should be advised to avoid eating before bedtime. Clients should remain in the upright position for at least 2 hours after eating.
- Sit up for at least 2 hours after eating.
This answer is correct because clients with GERD should be taught to remain upright after eating to allow for complete digestion of food. This will help prevent the backflow of stomach contents into the esophagus which causes the burning pain within the chest and esophagus for these clients.
- Increase the amount of sodium included in the diet.
This answer choice is not the best answer. The amount of sodium that a client with GERD consumes is not the priority teaching. The priority teaching is to remain sitting upright for at least 2 hours following eating to decrease intensity of symptoms.
The focus of this question is the nutritional teaching of a client with newly diagnosed GERD. These clients should be instructed to remain upright for 2-3 hours after eating to avoid the pain that accompanies gastric reflux.
GERD causes the reflux of stomach contents back up into the esophagus after eating due to a weak esophageal sphincter. The most common manifestation of GERD is burning chest/esophageal pain after eating. Clients with GERD should therefore be taught to remain upright for at least 2 hours after eating to give food time to fully digest which will prevent the reflux of stomach contents up into the esophagus.
Test Taking Tip
Always make sure to relate the priority client teaching back to the patho of the disease process when answering these questions. An understanding of the underlying patho of GERD is critical to be able to understand the importance of remaining upright after eating.