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Which of the following are contraindications for administering a tap water enerna? (Select all that apply)

Electrolyte imbalance risk

Acute appendicitis

Severe dehydration

Regular use of laxatives

History of bowel surgery

Normal bowel function

Increased fluid intake

Answer and Explanation

Correct Answer : A,B,C,E

Rationale:
A. Tap water enemas are hypotonic, and repeated or large-volume use can lead to hyponatremia or other electrolyte disturbances, particularly in infants, elderly clients, or those with renal or cardiac issues.

B. Administering a tap water enema in a client with suspected appendicitis can increase intra-abdominal pressure, potentially causing perforation or worsening the condition.

C. Tap water enemas can further disrupt fluid and electrolyte balance in clients who are already dehydrated, exacerbating their condition.

D. Regular use of laxatives is not a strict contraindication for a tap water enema but may reduce its effectiveness over time due to bowel adaptation.

E. Clients with recent bowel surgery or structural abnormalities are at higher risk for perforation or injury when receiving an enema.

F. Tap water enemas are not indicated for clients with normal bowel function because they are unnecessary and can cause discomfort or dependence.

G. While maintaining hydration is important, it does not contraindicate the use of a tap water enema; it may actually support bowel function.

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Correct Answer is C

Explanation

Rationale:

A. Magnesium levels may actually drop, not rise, during refeeding syndrome due to intracellular shifts.

B. Calcium levels are typically not elevated as a direct result of refeeding syndrome.

C. Refeeding syndrome occurs when malnourished patients receive rapid carbohydrate reintroduction, triggering insulin release. This drives phosphate, potassium, and magnesium into cells, with phosphate depletion being the hallmark and most clinically significant electrolyte disturbance. Hypophosphatemia can cause muscle weakness, respiratory failure, and cardiac dysfunction.

D. Sodium levels may fluctuate, but hyponatremia is not the primary concern in refeeding syndrome.

A. To replace lost blood components B. To restore extracellular fluid volume C. To replenish electrolytes rapidly D. To correct metabolic acidosis

Correct Answer is B

Explanation

Rationale:
A. Replacing lost blood components requires blood products, not isotonic crystalloids.
B. Isotonic crystalloid fluids (e.g., 0.9% sodium chloride, lactated Ringer’s) are administered to restore extracellular fluid volume in clients with fluid volume deficit.
C. While isotonic solutions contain electrolytes, their primary purpose is volume replacement, not rapid electrolyte correction.
D. Correcting metabolic acidosis may require specific interventions; isotonic fluids alone do not address acid-base imbalances.

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Which of the following are contraindications for administering a tap water enerna? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which electrolyte imbalance is most commonly associated with refeeding syndrome?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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