A nurse is about to administer a bolus enteral feeding to a client who is on bedrest. How does the nurse position the client during the feeding?

On left side, with the knees bent

With the head of the bed elevated 30-45 degrees

On the right side, with a pillow behind the back

With the head of the bed elevated 15 degree

Answer and Explanation

The Correct Answer is B

B. Elevating the head of the bed to 30-45 degrees is the recommended position for administering enteral feeding to reduce the risk of aspiration. This semi-upright position helps promote gastric emptying and reduces the likelihood of reflux or regurgitation of the feed into the lungs. It also allows for better tolerance of the feeding and minimizes the risk of complications.
A. Positioning the client on the left side with the knees bent is not typically recommended for enteral feeding. This position may increase the risk of aspiration, especially if the client has impaired swallowing or if there are issues with gastric emptying. It may also not be the most comfortable or practical position for administering enteral feeding.
C. Positioning the client on the right side with a pillow behind the back is not a standard practice for administering enteral feeding. This position may not provide optimal access for administering the feed, and it does not offer the benefits of head elevation to reduce the risk of aspiration.

D. Elevating the head of the bed to only 15 degrees may not provide sufficient upright positioning to reduce the risk of aspiration during enteral feeding. While it is better than lying completely flat, a higher degree of elevation (30-45 degrees) is generally recommended for optimal safety and effectiveness of enteral feeding.

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Correct Answer is A

Explanation

A. These are indicative of inflammation within the vein, which is characteristic of phlebitis. Warmth is a common sign of inflammation, and the palpable cord suggests that the vein may be hardened or cord- like due to inflammation and irritation.
B. While this could indicate some form of vascular injury or extravasation, it is not a typical presentation of phlebitis. Phlebitis involves inflammation of the vein, which may cause redness, warmth, and tenderness along the course of the vein, but it typically does not manifest as a raised ecchymotic (bruised) area.
C. Swelling occurs due to inflammation within the vein, and tenderness is often present as a result of the irritation and inflammation. These symptoms are commonly observed in cases of phlebitis but are not specific.
D. These are not typical signs of phlebitis. Blanching (turning white) and coolness of the skin may suggest reduced blood flow to the area, which could occur in cases of ischemia or thrombosis but are not characteristic of phlebitis.

A. pH 7.54. PaCO2 25. HCO3 24 B. pH 7.50, PaCO2 40, HCO3 28 C. pH 7.35, PaCO2 35, HCO3 22 D. pH 7.32. PaCO2 48, HCO3 24

Correct Answer is A

Explanation

A. In respiratory alkalosis, the pH is elevated (alkalotic), the PaCO2 (partial pressure of carbon dioxide) is decreased (hypocapnia), and the HCO3 (bicarbonate) level may be within normal limits or slightly decreased due to compensatory mechanisms. In this option, the pH is elevated (7.54), the PaCO2 is decreased (25), and the HCO3 level is within normal limits (24). These findings support respiratory alkalosis.
B. pH 7.50, PaCO2 40, HCO3 28: In this option, the pH is elevated (7.50), the PaCO2 is within normal limits (40), and the HCO3 level is elevated (28). These findings are not consistent with respiratory alkalosis. Instead, they suggest metabolic alkalosis, where both the pH and bicarbonate levels are elevated.
C. pH 7.35, PaCO2 35, HCO3 22: In this option, the pH is within normal limits (7.35), the PaCO2 is within normal limits (35), and the HCO3 level is within normal limits (22). These findings are not consistent with respiratory alkalosis.
D. pH 7.32. PaCO2 48, HCO3 24: In respiratory alkalosis, the pH is elevated (alkalotic), the PaCO2 is decreased (hypocapnia), and the HCO3 level may be within normal limits or slightly decreased due to compensatory mechanisms. In this option, the pH is within normal limits (7.32), the PaCO2 is elevated (48), and the HCO3 level is within normal limits (24). These findings are not consistent with respiratory alkalosis.

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A nurse is about to administer a bolus enteral feeding to a client who is on bedrest. How does the nurse position the client during the feeding?

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