A nurse is assessing a client who is receiving enteral feedings via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?
Switch to a lactose-free formula.
Reposition the NG tube.
Increase the rate of formula delivery.
Add water to the formula.
The Correct Answer is D
A. Switch to a lactose-free formula – A lactose-free formula is necessary for clients with lactose intolerance but does not address the issue of hyperosmolar dehydration, which results from insufficient free water intake rather than intolerance to lactose.
B. Reposition the NG tube – Repositioning the tube is necessary if there is displacement, but it does not treat dehydration caused by hyperosmolar feedings.
C. Increase the rate of formula delivery – Increasing the rate can worsen dehydration by further increasing the solute load, leading to a greater fluid shift from intracellular to extracellular spaces.
D. Add water to the formula – This is the correct answer because hyperosmolar dehydration occurs when high-solute enteral formulas pull water into the intestines, leading to excessive fluid loss. To prevent this, the nurse should ensure the client receives adequate free water flushes alongside tube feedings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Influenza – The first dose of the influenza vaccine is recommended at 6 months, not 2 months.
B. Hepatitis A – Hepatitis A vaccine is typically given at 12-23 months, not at 2 months.
C. Varicella – The varicella (chickenpox) vaccine is given at 12-15 months, so it is not appropriate for a 2-month-old.
D. Rotavirus – This is the correct answer. The rotavirus vaccine is recommended at 2 months, 4 months, and possibly 6 months, depending on the vaccine brand used.
Correct Answer is B
Explanation
A. Pour cool water over the client's perineum – Warm, not cool, water is more effective in relaxing the urinary sphincter to promote urination.
B. Turn on the faucets in the client's sink – The sound of running water can trigger the urge to urinate through a reflex mechanism, making this the best option.
C. Tell the client to gently stroke her lower abdomen – This is not an effective technique for stimulating urination.
D. Instruct the client to lean slightly backward – Positioning does not significantly influence urination while using a bedpan.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.