A nurse administers 200 mL of enteral nutrition via a client’s gastrostomy (GT) tube. The nurse flushes the feed bolus with 30 mL of water before and after the feed. How many mL does the nurse document as intake in the I&O?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Choice A reason: Consulting the family priest may provide spiritual support and guidance to the family, but it is not the most appropriate action for resolving a medical and ethical dilemma. The family priest may not have the necessary medical or ethical expertise to address the complexities of the situation

Choice B reason: The ethics committee is the appropriate body to consult in this situation. Ethics committees are composed of healthcare professionals, ethicists, and legal advisors who can provide guidance on complex ethical issues. They can help navigate the conflict between the parents’ religious beliefs and the medical necessity of the blood transfusion for the newborn. The committee can also ensure that the hospital’s actions align with legal and ethical standards.

Choice C reason: The Joint Commission is an accrediting body for healthcare organizations and does not provide direct assistance in individual patient care situations. While the Joint Commission sets standards for ethical practices, it is not involved in resolving specific ethical dilemmas at the patient level.

Choice D reason: The blood bank is responsible for the collection, testing, and distribution of blood products. While they can provide information about blood transfusions, they are not equipped to handle ethical conflicts related to the refusal of blood transfusions on religious grounds. The ethics committee is better suited for this role.

Choice A Reason:

A 24-hour urinary output of 380 mL indicates oliguria. Oliguria is defined as a urine output of less than 400-500 mL per day in adults. This condition can be caused by various factors, including dehydration, kidney dysfunction, or postoperative complications. Monitoring urine output is crucial for assessing kidney function and overall fluid balance, especially after major surgeries like a colon resection.

Choice B Reason:

A 24-hour urinary output of 550 mL is slightly above the threshold for oliguria. While it is still relatively low, it does not meet the strict criteria for oliguria, which is typically defined as less than 400-500 mL per day. This output suggests that the client is producing an adequate amount of urine, though it may still warrant close monitoring to ensure it does not decrease further.

Choice C Reason:

A 24-hour urinary output of 600 mL is within the normal range and does not indicate oliguria. Normal urine output for adults is generally considered to be around 800-2000 mL per day, depending on fluid intake and other factors. This output suggests that the client’s kidneys are functioning properly and that there is no immediate concern for oliguria.

Choice D Reason:

A 24-hour urinary output of 720 mL is also within the normal range and does not indicate oliguria. This output is closer to the lower end of the normal range but still suggests adequate kidney function. It is important to continue monitoring the client’s urine output to ensure it remains within a healthy range, especially after surgery.