A nurse is caring for a client who is receiving continuous enteral nutrition and is experiencing diarrhea. Which of the following actions should the nurse take?
Warm the formula to room temperature before infusing.
Increase the rate of infusion.
Change to a low-calorie formula if diarrhea persists.
Replace the extension tubing every 48 hr.
The Correct Answer is A
Choice A reason: Warming the formula to room temperature can help reduce the osmotic load and prevent diarrhea in clients receiving enteral nutrition. Cold formula can also cause abdominal cramping and discomfort.
Choice B reason: Increasing the rate of infusion can worsen diarrhea by increasing the osmotic load and the risk of bacterial overgrowth. The rate of infusion should be adjusted based on the client's tolerance and nutritional needs.
Choice C reason: Changing to a low-calorie formula is not indicated for diarrhea. Low-calorie formulas are usually high in osmolality and can cause more water to be drawn into the intestinal lumen, leading to diarrhea. A low-residue or isotonic formula may be more appropriate.
Choice D reason: Replacing the extension tubing every 48 hr is not enough to prevent diarrhea. The extension tubing should be replaced every 24 hr or with each new container of formula to reduce the risk of bacterial contamination and infection.
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Correct Answer is C
Explanation
Choice A reason: The standard DASH diet limits sodium intake to 2,300 milligrams per day, which is about the amount of sodium in 1 teaspoon of table salt¹. A lower sodium version of DASH restricts sodium to 1,500 milligrams per day, which may lower blood pressure even further¹. Therefore, limiting sodium intake to 3,200 milligrams per day is not consistent with the DASH diet.
Choice B reason: The DASH diet recommends eating fewer refined carbohydrates and less sugar, as they can increase blood pressure and cholesterol levels². Instead, the DASH diet emphasizes eating more whole grains, fruits, and vegetables, which are rich in fiber, potassium, calcium, and magnesium².
Choice C reason: The DASH diet encourages consuming foods that are high in calcium, such as fat-free or low-fat dairy products, fish, beans, and nuts¹. Calcium is a mineral that helps regulate blood pressure and supports bone health³. Studies have shown that increasing calcium intake can lower blood pressure in people with hypertension³.
Choice D reason: The DASH diet advises limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils¹. Saturated fat can raise blood pressure and cholesterol levels, which can increase the risk of heart disease and stroke. The DASH diet recommends consuming no more than six percent of total calories from saturated fat¹.
Correct Answer is B
Explanation
The correct answer is: b. Offer the client frozen bananas as a snack.
Choice A: Discourage the use of a straw
Discouraging the use of a straw is not the best intervention for a client with stomatitis following radiation therapy. While using a straw might cause some discomfort, it is not a primary concern. The focus should be on providing soothing and non-irritating foods.
Choice B: Offer the client frozen bananas as a snack
Offering the client frozen bananas as a snack is an appropriate intervention. Frozen bananas can provide a soothing effect on the inflamed oral tissues and are less likely to cause irritation compared to other foods. They are also nutritious and easy to consume, making them a suitable option for clients with stomatitis.
Choice C: Serve the client hot meals
Serving hot meals is not recommended for clients with stomatitis. Hot foods can exacerbate the discomfort and irritation in the mouth, making it more painful for the client to eat. It is better to serve foods at a moderate or cool temperature to avoid further irritation.
Choice D: Avoid serving sauces or gravies
Avoiding sauces or gravies is not the best intervention for a client with stomatitis. While some sauces or gravies might be irritating, others can be soothing and help make the food easier to swallow. The key is to choose mild and non-spicy options that do not irritate the oral tissues.
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