A nurse is teaching a client who is receiving enteral nutrition via bolus feedings. Which of the following statements by the client indicates an understanding of the teaching?

A. Increased thirst: This is typically a manifestation of hyperglycemia rather than hypoglycemia. Hyperglycemia can lead to dehydration due to the body’s attempt to flush out excess glucose through urine, which then causes increased thirst.
B. Urinary frequency: Urinary frequency is also a symptom commonly associated with hyperglycemia rather than hypoglycemia. When blood sugar levels are too high, the kidneys try to remove excess glucose, leading to frequent urination causing polyuria and is typically seen in hyperglycemic states, not in low blood sugar situations.
C. Weakness: Weakness is a classic symptom of hypoglycemia. When blood glucose levels drop too low, the body does not have enough fuel to function properly, leading to fatigue and weakness. This symptom is often experienced as one of the early signs of hypoglycemia and should be closely monitored in diabetic patients.
D. Skin flushing: Flushed skin is not a typical feature of hypoglycemia. Hypoglycemia more commonly causes cool, pale, and clammy skin due to sympathetic nervous system activation.

A. Place the client in semi-Fowler's position: Semi-Fowler’s position may provide some assistance with digestion and general comfort, but it is not optimal for reducing aspiration risk in clients with dysphagia. A more upright position high-Fowler's is preferred during meals to allow gravity to assist with safe swallowing and prevent food or liquid from entering the airway.
B. Encourage the client to drink a small amount of water after each bite: Encouraging the client to drink water between bites can increase the risk of aspiration. Thin liquids are particularly difficult to control in the mouth and pharynx for individuals with dysphagia and may enter the airway more easily. Thickened liquids are usually preferred instead, as they are easier to manage and reduce aspiration risk.
C. Offer the client liquids with a syringe during meals: Offering liquids with a syringe can create a strong, uncontrollable flow into the mouth increasing the risk of aspiration, especially in clients who already have impaired swallowing reflexes. Syringes are generally not used for feeding unless under very specific clinical circumstances and professional supervision.
D. Instruct the client to tuck their chin to their chest before swallowing: Tucking the chin to the chest (chin-tuck maneuver) helps close off the airway by narrowing the entrance to the trachea and directing the food or liquid more safely toward the esophagus. It is a simple yet effective method to significantly reduce aspiration risk in individuals with swallowing difficulties.