A nurse is assessing a client who is receiving enteral feedings via ah NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?
Add water to the formula.
Reposition the NG tube.
Increase the rate of formula delivery.
Switch to a lactose-free formula.
The Correct Answer is A
A. Adding water to the formula will decrease its osmolarity, reducing the risk of hyperosmolar dehydration. This action helps to dilute the formula and make it more isotonic, which is better tolerated by the client's gastrointestinal tract.
B. Repositioning the NG tube may be necessary if there are issues with tube placement or if the tube has migrated. However, it is not directly related to addressing hyperosmolar dehydration.
C. Increasing the rate of formula delivery may exacerbate hyperosmolar dehydration by introducing more concentrated formula into the gastrointestinal tract, leading to further dehydration.
D. Switching to a lactose-free formula may be appropriate if the client has lactose intolerance, but it does not address the issue of hyperosmolar dehydration. Adding water to the formula is the more appropriate intervention in this scenario to decrease osmolarity and prevent dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Incident report completed. A copy will be placed in the client's medical record." This statement indicates the completion of the incident report but lacks essential information about what incident occurred. It does not provide details necessary for understanding the nature of the incident.
B. "Prescribed dressing change was accidentally omitted during the previous shift." This statement clearly identifies the nature of the incident, stating that a prescribed dressing change was missed. It provides factual information without assigning blame, which is appropriate for an incident report.
C. "A nurse accidentally omitted a prescribed dressing change. Will notify the provider tomorrow." While this statement acknowledges the omission, it lacks details about the incident and focuses on future actions rather than accurately documenting what occurred.
D. "Unable to complete a prescribed dressing change. However, dressing did not appear to be soiled." This statement does not accurately represent the situation. It implies that the dressing change was not completed due to the dressing not appearing soiled, which may not be the case. It does not acknowledge the omission of the prescribed dressing change.
Correct Answer is B
Explanation
A. "I will take the medication in the morning." - Metformin extended-release tablets are typically taken with the evening meal to minimize gastrointestinal side effects. Taking it in the morning may increase the risk of side effects during the day.
B. "I will avoid crushing this medication." - Metformin extended-release tablets should not be crushed, chewed, or broken, as doing so can disrupt the extended-release mechanism, leading to an increased risk of adverse effects or decreased efficacy.
C. "I will take the medication on an empty stomach." - While metformin can be taken with or without food, it is generally recommended to take it with meals to reduce gastrointestinal side effects. Taking it on an empty stomach may increase the risk of nausea or upset stomach.
D. "I will expect to gain weight." - Weight loss is a common side effect of metformin, particularly in individuals with type 2 diabetes. Therefore, expecting weight gain would indicate a misunderstanding of the medication's effects.
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