A nurse is teaching the partner of a client about administering intermittent enteral feedings. Which of the following instructions should the nurse include?

Choice A reason: "Limit the number of fast-food meals to five each week." is not a good information to include, as it implies that fast-food meals are acceptable as long as they are not too frequent. The nurse should discourage the students from consuming fast-food meals, as they are high in fat, salt, sugar, and calories, and low in nutrients, fiber, and antioxidants. The nurse should advise the students to choose healthier options, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.

Choice B reason: "You should drink a glass of milk with breakfast." is a good information to include, as it promotes the intake of calcium, which is essential for bone health and growth. Adolescents need about 1,300 mg of calcium per day, which can be obtained from milk and other dairy products, such as cheese and yogurt. The nurse should encourage the students to drink milk with breakfast, as it can also provide protein, vitamin D, and other nutrients.

Choice C reason: "Most of your dietary intake should come from protein." is not a good information to include, as it suggests that protein is more important than other macronutrients, such as carbohydrates and fats. The nurse should explain to the students that protein is necessary for tissue repair, muscle development, and immune function, but it should not exceed 10 to 30 percent of the total caloric intake. The nurse should recommend the students to consume a balanced diet that includes carbohydrates, fats, and protein, as well as vitamins, minerals, and water.

Choice D reason: "Your total intake for the day should not exceed 1,000 calories." is not a good information to include, as it indicates that calorie restriction is the key to a healthy diet. The nurse should inform the students that calorie needs vary depending on age, gender, activity level, and growth rate, and that 1,000 calories is too low for most adolescents. The nurse should advise the students to eat enough calories to meet their energy and nutritional needs, and to avoid skipping meals or starving themselves.

Choice A reason: Administering the feeding by gravity drip is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Gravity drip can cause overfeeding, aspiration, and abdominal distension. The nurse should use an infusion pump to regulate the flow rate and volume of the feeding.

Choice B reason: Flushing the tubing with 10 mL water every 6 hr is an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Flushing the tubing prevents clogging, maintains patency, and hydrates the client. The nurse should also flush the tubing before and after medication administration, and whenever the feeding is interrupted or discontinued.

Choice C reason: Replacing the bag and tubing every 24 hr is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Replacing the bag and tubing every 24 hr does not prevent clogging, and may increase the risk of infection and contamination. The nurse should replace the bag and tubing every 48 hr, or as per facility policy.

Choice D reason: Heating the formula prior to infusion is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Heating the formula can alter its composition, reduce its nutritional value, and increase the risk of bacterial growth. The nurse should use room-temperature formula and store it in a refrigerator when not in use.