A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

Measure the client's gastric residual every 12 hr.

Keep the client's head elevated at 15° during feedings.

Obtain the client's electrolyte levels every 4 hr.

Flush the client's tube with 30 mL of water every 4 hr.

Answer and Explanation

The Correct Answer is D

A) Measure the client's gastric residual every 12 hr: While monitoring gastric residual volume is important to prevent complications such as aspiration or gastric distention, it is typically done prior to each intermittent feeding, not every 12 hours for clients receiving continuous enteral feedings. Continuous feeding does not necessitate less frequent monitoring of gastric residuals.

B) Keep the client's head elevated at 15° during feedings: Elevating the client's head during feedings helps reduce the risk of aspiration. However, this action is not specific to initiating continuous enteral feedings and should be maintained throughout the client's enteral feeding regimen.

C) Obtain the client's electrolyte levels every 4 hr: Monitoring electrolyte levels every 4 hours is not necessary as part of routine care for a client initiating continuous enteral feedings. While electrolyte levels may be monitored periodically, the frequency would depend on the client's clinical condition and the healthcare provider's orders.

D) Flush the client's tube with 30 mL of water every 4 hr: Flushing the client's tube with water helps maintain patency and prevent clogging, which is especially important for clients receiving continuous enteral feedings. This action helps ensure that the tube remains clear and functional, allowing for uninterrupted delivery of the enteral feeding solution.

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Correct Answer is A

Explanation

A) Identify the client's motivation: Understanding the client's motivation for wanting to lose weight is crucial as it helps the nurse tailor interventions and support strategies to align with the client's goals and values. By identifying the client's motivation, the nurse can determine what drives the client's desire to lose weight, whether it's improving health, enhancing self-esteem, or addressing specific concerns. This information forms the foundation for developing an effective and individualized care plan.

B) Refer the client to a dietitian: While a referral to a dietitian is an important step in the weight loss process, it may not be the first action the nurse takes. Before making a referral, it's essential to assess the client's motivation, readiness to change, and current understanding of weight loss strategies. This information helps ensure that the dietitian can provide targeted guidance and support based on the client's specific needs and preferences.

C) Set a weight loss goal: Setting a weight loss goal is an important aspect of the weight loss journey; however, it typically occurs after assessing the client's motivation and readiness to change. Setting realistic and achievable goals collaboratively with the client allows for better engagement and commitment to the weight loss plan. Without understanding the client's motivation and readiness, setting a goal may not be meaningful or sustainable.

D) Discuss behavior modification: Behavior modification strategies play a crucial role in achieving and maintaining weight loss success. However, before discussing specific behavior modification techniques, it's essential to assess the client's motivation, barriers to change, and current behaviors. Understanding these factors helps tailor behavior modification strategies to address the client's unique needs and challenges effectively.

A. Salami B. Barley C. Corn D. Wheat germ

Correct Answer is C

Explanation

A) Salami is typically not recommended for individuals with celiac disease because it often contains gluten as a filler or binder. Processed meats like salami may have additives or seasonings that contain gluten, so individuals with celiac disease should carefully read labels and choose gluten-free options.

B) Barley is a grain that contains gluten and is not suitable for individuals with celiac disease. It is commonly found in bread, cereals, soups, and other processed foods. Consuming barley can trigger adverse reactions in individuals with celiac disease due to the gluten content.

C) Corn is a suitable option for individuals with celiac disease who need to follow a gluten-free diet. Corn is naturally gluten-free and can be included in various forms, such as whole corn, cornmeal, or corn flour, in gluten-free recipes. It provides carbohydrates, fiber, vitamins, and minerals without containing gluten, making it a safe choice for those with celiac disease.

D) Wheat germ is derived from wheat, which contains gluten. Therefore, wheat germ is not appropriate for individuals with celiac disease as it can cause gluten-related symptoms. It's important for individuals with celiac disease to avoid all sources of gluten, including wheat and wheat-derived products like wheat germ.

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