A client is receiving total parenteral nutrition (TPN). The nurse enters the room and discovers that the container only has 15 minutes of solution left.
She calls the pharmacy and is told that the next bag will not be available for another hour.
What must the nurse do next?

Choice A rationale

Placing the client in a prone position is contraindicated during nasogastric tube insertion. This position does not facilitate the passage of the tube into the esophagus and can increase the risk of aspiration if the client were to vomit. The optimal position is high Fowler's, which utilizes gravity to aid tube advancement.

Choice B rationale

Measuring the nasogastric tube from the tip of the nose to the earlobe to the xiphoid process is the correct technique to estimate the length of the tube needed to reach the stomach. This method accounts for the distance from the nasal passage, down the pharynx and esophagus, to the stomach.

Choice C rationale

Instructing the client to place their chin to their chest and swallow helps to close the epiglottis, thereby preventing the nasogastric tube from entering the trachea and directing it towards the esophagus. Swallowing facilitates the downward movement of the tube with esophageal peristalsis.

Choice D rationale

Advancing the nasogastric tube quickly increases the client's discomfort and anxiety and elevates the risk of trauma to the nasal passages, pharynx, and esophagus. The tube should be advanced slowly and gently, allowing the client to swallow and cooperate during the procedure.

Choice A rationale

Memory loss is more commonly associated with neurological conditions, vitamin B12 deficiency, or aging, rather than a lack of dietary fiber. Fiber primarily affects the digestive system and blood sugar control, not cognitive function.

Choice B rationale

Bleeding gums are typically a sign of vitamin C deficiency (scurvy) or poor oral hygiene leading to gingivitis. While overall nutrition is important for oral health, a lack of fiber specifically does not directly cause bleeding gums.

Choice C rationale

Brittle hair can be a symptom of various nutritional deficiencies, including protein, biotin, and iron, but it is not a primary indicator of inadequate fiber intake. Fiber mainly impacts bowel function and glucose metabolism.

Choice D rationale

Constipation, characterized by infrequent or difficult bowel movements, is a well-established consequence of inadequate dietary fiber intake. Fiber adds bulk to the stool, absorbs water, and facilitates peristalsis, the muscular contractions that move stool through the intestines. A lack of fiber can lead to harder, drier stools that are more difficult to pass. .