What is the appropriate action for a charge nurse to instruct UAP when caring for a client with a hiatal hernia?

Elevating the head of the bed before the client begins to eat is significant for managing a hiatal hernia. This action helps reduce the risk of gastroesophageal reflux, which can occur when a portion of the stomach pushes through the diaphragm into the chest cavity. By positioning the client with an elevated head, gravity assists in keeping stomach contents where they belong, reducing the likelihood of discomfort and potential complications associated with the hernia.

The other actions may not provide the same level of benefit. For instance, changing the client's position frequently during meals could disrupt the digestion process and increase the likelihood of reflux. Encouraging large meals would be counterproductive, as it could increase abdominal pressure and exacerbate reflux symptoms. Assisting with ambulation immediately after eating might also provoke reflux by increasing the chances of stomach contents moving back up the esophagus due to activity shortly after a meal. Therefore, the instruction to elevate the head of the bed prior to eating supports a proactive approach to managing the condition effectively.