a. Heartburn is a burning sensation in the epigastric and sternal region.

It results from relaxation of the cardiac sphincter and the decreased tone and mobility of smooth muscles due to increased progesterone, thereby allowing for esophageal regurgitation, decreased emptying time of the stomach, and reverse peristalsis.

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Heartburn has nothing to do with the heart. It occurs more frequently as pregnancy advances as a result of decreased peristalsis and pressure of the growing fetus on the stomach.

b. Nursing interventions consist of advising the patient to:

(1) Not to lie flat after eating. Sitting or walking helps gravity move the food through the gastrointestinal tract.

(2) Drink a glass of milk about 1/2 hour before eating. This will inhibit the secretion of stomach acid.

(3) Avoid eating or drinking gas-forming foods or fluids (cabbage, beans, cokes, etc.).

(4) Not take any antacid unless ordered by her obstetric (OB) practitioner or physician. Sodium bicarbonate and Alka-Seltzer™ contain high amounts of sodium.

(5) Eat small, frequent, non-spicy, non-fried meals and drink adequate fluids.