The nurse has finished providing a tube feeding to a client. What should the nurse document about this procedure? (SELECT ALL THAT APPLY)
Solution provided
Name of physician prescribing the feeding
Client tolerance of the feeding
Amount of solution
Duration of the feeding
Correct Answer : A,C,D,E
A. Documenting the type of solution provided for tube feeding is essential for accurate record-keeping and continuity of care. This includes specifying the name and composition of the enteral formula used, such as standard polymeric, high-protein, elemental, or specialized formulas for specific medical conditions or nutritional needs.
C. Documenting the client's tolerance of the tube feeding is crucial for monitoring their response to the enteral nutrition. This includes assessing for signs of intolerance, such as nausea, vomiting, abdominal pain, bloating, diarrhea, or aspiration. Documenting tolerance helps guide adjustments to the feeding regimen and ensures patient safety and comfort.
D. Documenting the amount of solution administered during the tube feeding is essential for accurately monitoring the client's intake and ensuring that nutritional goals are met. This includes recording the volume of formula administered, as well as any additional flushes or medications given through the feeding tube.
E. Documenting the duration of the tube feeding session provides important information about the timing and frequency of feedings. This includes recording the start and end times of the feeding, as well as any interruptions or adjustments made during the procedure. Documenting the duration helps ensure consistency in the feeding regimen and facilitates effective communication among healthcare providers.
B. Documenting the name of the physician who prescribed the tube is not necessary.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. The sigmoid colon is the last part of the large intestine before the rectum. It functions to store fecal material and absorb water and electrolytes. Fecal material passing through the sigmoid colon tends to become more solid as water is absorbed, resulting in a more formed stool compared to other parts of the colon.
A. The transverse colon is located in the upper abdomen and is responsible for further absorption of water and electrolytes from the stool. Fecal material passing through the transverse colon tends to become more solid as water is absorbed, but it may not be as solid as stool from the descending colon or sigmoid colon.
B. The ascending colon is where stool is in a more liquid form as it moves up from the cecum. It undergoes further absorption of water and electrolytes as it travels through the colon, but it typically does not produce solid fecal output.
C. The ileum is the final portion of the small intestine and connects to the large intestine (colon). Stool passing through the ileum is still in a relatively liquid state as it contains undigested food particles, bile salts, and digestive enzymes. The primary function of the ileum is absorption of nutrients rather than water reabsorption, so fecal output from an ileostomy is usually more liquid.

Correct Answer is B
Explanation
B. Utilizing an interpreter allows for direct verbal communication between the nurse and the client in their primary language. This ensures accurate transmission of information and facilitates a better understanding of complex concepts. An interpreter can help bridge the language gap and facilitate effective communication during the teaching process.
A. Demonstrations can be effective for teaching clients, regardless of language barriers, as they rely on visual cues and hands-on learning. By demonstrating a procedure or technique and then asking the client to perform a return demonstration, the nurse can assess the client's understanding and competency. This method can be particularly useful when language barriers are present because it relies less on verbal communication.
C. Visual teaching aids, such as diagrams, pictures, charts, and videos, can be powerful tools for conveying information to clients with different primary languages. Visual aids are universal and can help overcome language barriers by presenting information in a way that is easily understood regardless of language proficiency. Using visual aids can enhance comprehension and retention of key concepts.
D. Providing written materials in the client's primary language can be helpful for reinforcing verbal instructions and providing reference materials for the client to review independently. Written materials allow clients to review information at their own pace and refer back to it as needed. However, it's important to ensure that the written materials are accurately translated and culturally appropriate for the client.
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