A client with gastroesophageal reflux disease (GERD) is talking to the nurse about ways to manage her condition. Which statement reflects an understanding of management of GERD?

  1. “I can elevate the head of my bed 6 to 12 inches to help prevent nighttime reflux.”
  2. “I can eat a large breakfast and smaller meals for lunch and dinner to help me feel better.”
  3. “Lying on my left side will promote oxygenation and frequent swallowing to help clear my esophagus.”
  4. “I should take liquid antacids to coat my esophagus and buffer acid 2 hours before I eat and 1 hour after meals.”
Number 1 is correct.
Rationale: Elevating the head of the bed with blocks or a large, wedge pillow can prevent reflux. Large meals should be avoided; instead the diet should consist of 4 to 6 small meals throughout the day. Lying on the right side, not the left, helps promote oxygenation and frequent swallowing to help clear the esophagus. Liquid antacids should be taken 1 hour before and 2 to 3 hours after meals.