A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?

A residual of 65 mL 1 hr postprandial.

A history of gastroesophageal reflux disease.

Receiving a high-osmolarity formula.

Sitting in high-Fowler's position during the feeding.

Answer and Explanation

The Correct Answer is B

A.   This amount of residual is generally considered safe; guidelines often cite higher residuals (e.g., >100 mL) as concerning.
B.   Clients with a history of gastroesophageal reflux disease (GERD) are at increased risk for aspiration, particularly when lying flat, because the lower esophageal sphincter may not function properly, allowing stomach contents to move back into the esophagus.
C.   While high-osmolarity formulas can contribute to diarrhea, they are not directly linked to an increased risk of aspiration.
D.   Sitting in a high-Fowler’s position (semi-upright) during feedings is actually recommended to reduce the risk of aspiration.

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Correct Answer is D

Explanation

A. Potatoes do not contain significant levels of tyramine and are generally safe to consume with MAOIs.
B. Grapefruit does not contain significant levels of tyramine and are generally safe to consume with MAOIs.
C. Eggs do not contain significant levels of tyramine and are generally safe to consume with MAOIs.

D. MAOIs (Monoamine Oxidase Inhibitors) require dietary restrictions to avoid tyramine, which is found in high levels in aged cheeses. High tyramine intake while on MAOIs can lead to hypertensive crises.

A. "Do you need information on hospice care?" B. "Would you like to talk to a counselor about advance directives?" C. "Would you like to speak to a spiritual advisor?" D. "Do you need a prescription for an antianxiety medication?"

Correct Answer is C

Explanation

A. While hospice care may be appropriate for the client, it does not directly address the client's reported depression.
B. Discussing advance directives is important for end-of-life care planning, but it may not address the client's current emotional needs.
C. Offering spiritual support acknowledges the client's emotional distress and provides an opportunity for comfort and guidance that aligns with the client's values and beliefs.
D. Offering medication without further assessment or exploration of the client's feelings may not be the most therapeutic response to the reported depression.

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A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?

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