A nurse is caring for a client who has malnutrition. Which of the following findings should the nurse report to the provider?

Choice A reason: Checking gastric residuals every 8 hr is not frequent enough, as it can miss signs of delayed gastric emptying, which can cause aspiration, nausea, vomiting, or abdominal distension. Gastric residuals should be checked every 4 hr.

Choice B reason: Returning gastric contents if residual is less than 250 mL is not advisable, as it can increase the risk of infection, contamination, or electrolyte imbalance. Gastric contents should be discarded if residual is more than 100 mL.

Choice C reason: Measuring the pH of gastric residual every 24 hr is not necessary, as it does not reflect the effectiveness or tolerance of the feeding. The pH of gastric residual should be checked before each feeding or every 6 to 8 hr to confirm tube placement and prevent misconnection.

Choice D reason: Flushing the tube with 15 mL of water every 4 hr is a correct action, as it can prevent clogging, maintain patency, and clear the tube of formula residue. Water should also be used to flush the tube before and after each medication administration.

Choice A reason: Providing a snack 30 min before treatments can worsen nausea and diarrhea, as food can stimulate gastric motility and secretion. It is better to avoid eating for at least 2 hours before and after treatments.

Choice B reason: Ensuring foods are served hot can increase nausea and diarrhea, as hot foods can have strong smells and irritate the digestive tract. It is better to serve foods at room temperature or cold.

Choice C reason: Administering antiemetics on a schedule can prevent nausea and vomiting, which can lead to dehydration and electrolyte imbalance. Antiemetics can also reduce abdominal cramps and spasms that cause diarrhea.

Choice D reason: Serving low carbohydrate meals can aggravate diarrhea, as carbohydrates are the main source of energy for the body. It is better to serve high carbohydrate meals that are easy to digest, such as rice, potatoes, bread, or crackers.