A nurse is caring for a client who has a small-bore jejunostomy tube and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?

Choice A reason: Cheddar cheese is not a good food choice for maintaining water intake, as it contains only about 37% water¹. Cheese and other dairy products are also high in sodium, which can increase the water loss through urine.

Choice B reason: Broccoli is a good food choice for maintaining water intake, as it contains about 89% water². Broccoli and other vegetables are also rich in vitamins, minerals, and antioxidants, which can benefit the child's health and hydration.

Choice C reason: Whole-wheat bread is not a good food choice for maintaining water intake, as it contains only about 35% water³. Bread and other grains are also high in carbohydrates, which can increase the water retention in the body.

Choice D reason: Almonds are not a good food choice for maintaining water intake, as they contain only about 4% water⁴. Almonds and other nuts are also high in fat and calories, which can contribute to weight gain and inflammation.

Choice A reason: Hypernatremia is not a sign of water intoxication, but rather the opposite condition. Hypernatremia means high sodium levels in the blood, which can occur when the body loses more water than sodium, such as in dehydration, diabetes insipidus, or excessive salt intake. Water intoxication causes hyponatremia, which means low sodium levels in the blood, due to excessive water intake or retention.

Choice B reason: Weak pulses are not a specific sign of water intoxication, but rather a general sign of poor perfusion or circulation. Weak pulses can have many causes, such as hypotension, shock, heart failure, or peripheral vascular disease. Water intoxication can cause hypotension, but it can also cause hypertension, depending on the volume status of the client.

Choice C reason: Muscle weakness is a sign of water intoxication, as it reflects the effect of low sodium levels on the neuromuscular system. Sodium is essential for nerve and muscle function, as it helps generate electrical impulses and contractions. When sodium levels drop too low, the nerves and muscles become less responsive and weaker. Other signs of water intoxication affecting the nervous system include confusion, headache, seizures, and coma.

Choice D reason: Exaggerated reflexes are not a sign of water intoxication, but rather a sign of hyperreflexia, which is a condition of overactive reflexes. Hyperreflexia can have many causes, such as spinal cord injury, stroke, multiple sclerosis, or electrolyte imbalance. Water intoxication can cause electrolyte imbalance, but it usually leads to hyporeflexia, which is a condition of reduced or absent reflexes.