The nurse is caring for a client at 21 weeks gestation with reports of occasional, bothersome heartburn (pyrosis). Which of the following lifestyle changes should the nurse recommend? Select all that apply.

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Pyrosis, or heartburn, is common during pregnancy due to an increase of the progesterone hormone and uterine enlargement that displaces the stomach. Progesterone relaxes smooth muscles, resulting in esophageal sphincter relaxation. Gastric contents are then regurgitated, usually causing a burning sensation behind the sternum. The nurse should educate the client about lifestyle changes for reducing heartburn, such as: Keep the head of the bed elevated using pillows Sit upright after meals Eat small, frequent meals (Option C) Avoid tight-fitting clothing Eliminate common dietary triggers (eg, fried/fatty foods, caffeine, citrus, chocolate, spicy foods, tomatoes, carbonated drinks, peppermint) (Option D) (Option A) Dairy products do not typically lead to heartburn and are an important source of calcium during pregnancy. (Option B) The client can minimize gastric distension, gastric acid production, and subsequent reflux by drinking small amounts of fluid while eating and avoiding overeating. The client should be instructed to cluster fluid intake between meals instead. (Option E) Lying down immediately after eating exacerbates reflux and may lead to more discomfort. Educational objective: Pyrosis is common during pregnancy due to an increase of the progesterone hormone, which causes the esophageal sphincter to relax. Lifestyle changes to reduce symptoms include eating smaller meals, avoiding trigger foods (eg, fried/fatty food), maintaining an upright position after meals, and drinking fluids mostly between meals.

The Nurse Is Caring for a Client at 21 Weeks