A nurse is contributing to the plan of care for a client who has a gastrostomy tube through which he is receiving continuous enteral feedings. Which of the following interventions should the nurse include in the plan?

Keep the head of the bed elevated at 15 degrees.

Place enough formula in the feeding bag to last for 8 hr of continuous feeding

Flush the tube with 30 ml of water every 4 hr.

Change the feeding bag and tubing every 72 hr.

Answer and Explanation

The Correct Answer is C

A. Keep the head of the bed elevated at 15 degrees.

This is not sufficient for preventing aspiration and ensuring proper digestion. The head of the bed should be elevated at least 30 degrees to reduce the risk of aspiration and promote better digestion of enteral feedings.

B. Place enough formula in the feeding bag to last for 8 hr of continuous feeding: It is recommended to change the feeding formula and bag every 24 hours. Placing formula for an extended period can increase the risk of bacterial growth.

C. Flush the tube with 30 ml of water every 4 hr: Regular flushing of the tube helps maintain patency, prevents clogging, and ensures proper hydration. Flushing every 4 hours is a standard practice for continuous feeding.

D. Change the feeding bag and tubing every 72 hr: Feeding bags and tubing should be changed more frequently, typically every 24 hours, to reduce the risk of infection.

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Correct Answer is C

Explanation

A. Diabetes mellitus
Diabetes mellitus can cause easy bruising and slow wound healing, but it is not typically associated with frequent nosebleeds.

B. Hepatitis A
Hepatitis A primarily affects the liver and does not cause frequent bruising and nosebleeds.

C. Cirrhosis
Cirrhosis, which is scarring of the liver tissue due to long-term liver damage, can lead to impaired liver function. One consequence of cirrhosis is decreased production of clotting factors, which can result in easy bruising. Additionally, the enlarged spleen in cirrhosis can lead to thrombocytopenia (low platelet count), contributing to bleeding tendencies, including nosebleeds. Cirrhosis is the most likely condition given the symptoms described.

D. Cholecystitis
Cholecystitis is inflammation of the gallbladder and is not directly associated with frequent bruising and nosebleeds.

A. A high protein diet B. A high fiber diet C. A low sodium diet D. A low fat diet

Correct Answer is D

Explanation

A. A high protein diet: While protein is essential, there is no specific indication for a high protein diet in managing chronic cholecystitis. The focus is more on reducing fat intake.

B. A high fiber diet: While a high fiber diet is generally healthy, it is not specifically emphasized for managing chronic cholecystitis. The emphasis is on reducing fat intake.

C. A low sodium diet: Sodium restriction is important for conditions like hypertension and heart failure. While it’s good for overall health, it's not a primary focus for managing chronic cholecystitis. Again, the emphasis is on reducing fat intake to prevent gallbladder attacks.

D. A low-fat diet

This is the correct answer. A low-fat diet is often recommended for individuals with chronic cholecystitis or gallstones. A low-fat diet helps to reduce the workload on the gallbladder, as fatty foods can trigger gallbladder attacks.

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A nurse is contributing to the plan of care for a client who has a gastrostomy tube through which he is receiving continuous enteral feedings. Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

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