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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. This intervention promotes emotional expression and allows the client to verbalize their fears, worries, and uncertainties related to the cancer diagnosis. Encouraging the client to express their feelings fosters a sense of emotional support, validation, and empathy, which are essential for coping with the emotional impact of the diagnosis.
C. Cancer diagnosis and treatment often involve multiple appointments, tests, and treatments, which can be overwhelming for the client. Assisting the client with time management and priorities can help alleviate stress and enhance coping by providing structure, organization, and support in managing the demands of the treatment plan and daily life responsibilities.
D. Involving the client in decision-making and allowing them input into the treatment plan empowers the client and promotes a sense of control and autonomy over their care. Collaborative decision-making enhances the client's engagement, adherence, and satisfaction with the treatment plan, which are essential for successful coping and treatment outcomes.
B. Telling the client what coping skills to use may not be the most effective approach, as it disregards the individuality of the client's coping mechanisms and preferences. Instead, the nurse should explore with the client what coping strategies they have used in the past and provide guidance and support in identifying and implementing effective coping strategies that align with the client's needs and preferences.
E. Providing extensive instructions about the treatment plan and prognosis is important for promoting understanding, informed decision-making, and adherence to the treatment plan. However, the timing and amount of information should be tailored to the client's readiness and preferences. Too much information too soon may overwhelm the client and hinder coping, while inadequate information may lead to uncertainty and anxiety. Therefore, the nurse should provide information in a clear, empathetic, and supportive manner, ensuring that the client's informational needs are met while respecting their emotional readiness.
Correct Answer is D
Explanation
D. As individuals age, there is a natural decline in the amount of deep sleep (slow-wave sleep or Stage N3 sleep) they experience. Older adults tend to spend less time in deep sleep and may experience more fragmented sleep patterns, with more frequent awakenings during the night. This reduction in deep sleep is a normal part of the aging process and is associated with changes in sleep architecture and physiology.
A. Research indicates that a significant portion of the population does not get enough sleep, with many adults experiencing sleep deprivation due to various factors such as lifestyle, work schedules, and sleep disorders.
B. Teenagers often have a natural tendency to stay up later and have difficulty waking up early due to changes in their circadian rhythm during adolescence. This shift in sleep patterns, known as delayed sleep phase syndrome, can result in later bedtimes and waking times for teenagers.
C. Sleep needs typically change over the course of a person's lifetime. Infants and young children require more sleep than adults, with sleep duration gradually decreasing as individuals age.
Additionally, factors such as lifestyle, health status, and environmental influences can affect sleep needs at different stages of life.
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