A nurse is caring for a client diagnosed with a hiatal hernia. The client complains of abdominal pain and sternal pain after eating. The pain makes it difficult for him to sleep. Which of the following instructions should the nurse recommend to this client?

1. Avoid constrictive clothing
2. Lie down for 30 minutes after eating
3. Decrease intake of caffeine and spicy food
4. Eat three meals per day
5. Sleep in semi-Fowler’s position
6. Maintain a normal body weight

Correct Answers: 1, 3, 5, and 6

Rationale
To reduce gastric reflux, the nurse should recommend that the client sleep with his upper body elevated; lose weight, if obese; avoid constrictive clothing, caffeine, and spicy foods; remain upright for 2 hours after eating; and eat small, frequent meals.