A nurse is caring for a client who has a nasogastric tube and is receiving a continuous tube feeding with a high-protein formula. Which of the following actions should the nurse take to prevent the tubing from clogging?
Flush the tubing with 10 mL water every 4 hours.
Replace the bag and tubing every 24 hours.
Administer the feeding by gravity drip.
Heat the formula prior to infusion.
The Correct Answer is A
Choice A reason: Flushing the tubing with water every 4 hours can prevent the tubing from clogging by clearing any residual formula or medication from the lumen.
Choice B reason: Replacing the bag and tubing every 24 hours can prevent bacterial contamination, but it does not prevent the tubing from clogging.
Choice C reason: Administering the feeding by gravity drip can cause overfeeding, aspiration, or diarrhea, but it does not prevent the tubing from clogging.
Choice D reason: Heating the formula prior to infusion can cause bacterial growth, nutrient loss, or burns, but it does not prevent the tubing from clogging.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Creatinine 0.8 mg/dL is within the normal range (0.6-1.2), and it does not indicate fluid volume excess. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. High creatinine levels can indicate kidney damage or impaired renal function.
Choice B reason: Hgb 15 g/dL is within the normal range (13-17 for men, 12-16 for women), and it does not indicate fluid volume excess. Hgb stands for hemoglobin, which is a protein in red blood cells that carries oxygen to the tissues. Low hemoglobin levels can indicate anemia, bleeding, or hemolysis.
Choice C reason: BUN 18 mg/dL is within the normal range (7-20), and it does not indicate fluid volume excess. BUN stands for blood urea nitrogen, which is a waste product of protein metabolism that is filtered by the kidneys. High BUN levels can indicate dehydration, kidney damage, or high protein intake.
Choice D reason: Sodium 149 mEq/L is high and indicates fluid volume excess. Sodium is an electrolyte that helps maintain fluid balance, blood pressure, and nerve impulses. High sodium levels can cause fluid retention, edema, hypertension, and heart failure.
Correct Answer is D
Explanation
Choice A reason: The client's creatinine level of 1.0 mg/dL is within the normal range, but it does not indicate that the treatment for benign prostatic hyperplasia has been effective. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in urine. It reflects the kidney function, not the prostate condition.
Choice B reason: The client's urine output of 35 mL/hr is below the normal range, which is 40 to 60 mL/hr. This indicates that the client may have dehydration, kidney impairment, or urinary retention, which are complications of benign prostatic hyperplasia. A low urine output does not indicate that the treatment has been effective.
Choice C reason: The client's stool color and consistency are not related to the treatment for benign prostatic hyperplasia. Stool characteristics depend on various factors, such as diet, medication, and bowel function. A soft, brown stool does not indicate that the treatment has been effective.
Choice D reason: The client's ability to urinate without straining is a sign that the treatment for benign prostatic hyperplasia has been effective. Benign prostatic hyperplasia is a condition in which the prostate gland enlarges and compresses the urethra, causing difficulty in urination. A treatment that reduces the size of the prostate or relaxes the bladder neck muscles can improve the urine flow and reduce the straining.
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