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: Reporting ability to complete ADLs is not a specific finding that indicates that probiotic therapy is effective. Ability to complete ADLs depends on various factors, such as energy level, muscle strength, mobility, cognition, and motivation. Ability to complete ADLs may improve with parenteral nutrition, but not necessarily with probiotic therapy.

Choice B reason: Having pink mucous membranes is not a specific finding that indicates that probiotic therapy is effective. Pink mucous membranes reflect adequate hydration and oxygenation status, which are important for overall health, but not directly related to probiotic therapy.

Choice C reason: Having blood glucose level within the expected reference range is not a specific finding that indicates that probiotic therapy is effective. Blood glucose level is influenced by carbohydrate intake, insulin production, and medication use, which are related to parenteral nutrition, but not probiotic therapy.

Choice D reason: Having soft, formed bowel movements is a specific finding that indicates that probiotic therapy is effective. Probiotic therapy is the use of beneficial bacteria or yeast to restore the normal flora and function of the gastrointestinal tract, which can prevent or treat diarrhea, constipation, or infection. Having soft, formed bowel movements shows that the client has a healthy and balanced gut microbiome.

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.