To prevent gastroesophageal reflux in a male client with a hiatal hernia, the nurse should provide which of the following discharge instructions?
A. “Lie down after meals to promote digestion.”
B. “Avoid coffee and alcoholic beverages.”
C. “Take antacids with meals.”
D. “Limit fluid intake with meals.”
Correct Answer: B. “Avoid coffee and alcoholic beverages.”
To prevent reflux of stomach acid into the esophagus, the nurse should advise the client to avoid foods and beverages that increase stomach acids, such as coffee and alcohol. Instruct the patient regarding avoidance of alcohol, smoking, and caffeinated beverages. These increase acid production and may cause esophageal spasms.
Option A: The nurse also should teach the client to avoid lying down after meals, which can aggravate reflux. Instruct to remain in an upright position at least 2 hours after meals; avoiding eating 3 hours before bedtime. This helps control reflux and causes less irritation from reflux action into the esophagus.
Option C: The nurse also should teach the client to take antacids after eating. Instruct the patient in medications, effects, side effects, and to report to the physician if symptoms persist despite medication treatment. Promotes knowledge, facilitates compliance with treatment, and allows for prompt identification of potential need for changes in medication regimen to prevent complications.
Option D: The client need not limit fluid intake with meals as long as the fluids aren’t gastric irritants. Instruct the patient to avoid highly seasoned food, acidic juices, alcoholic drinks, bedtime snacks, and foods high in fat. These can reduce the lower esophageal sphincter pressure.
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