A nurse is admitting a client with pneumonia. Which of the following orders should be implemented first?

Choice A reason: Malodorous flatus 2 days post-colostomy is normal, indicating bowel function resumption. This aligns with postoperative colostomy expectations, making it the correct interpretation by the nurse, as flatus is an expected milestone in the client’s recovery process.

Choice B reason: Ischemic bowel causes pain, fever, or absent output, not just malodorous flatus, which is normal post-colostomy. This is incorrect, as it misinterprets a typical finding as a serious complication in the nurse’s assessment of the client’s stoma.

Choice C reason: Flatus doesn’t indicate the need for a nasogastric tube, which is used for obstruction or ileus. Normal flatus is expected, making this incorrect, as it wrongly suggests intervention for a typical post-colostomy finding in the nurse’s evaluation.

Choice D reason: Malodorous flatus is unrelated to preoperative bowel preparation; it’s a normal post-colostomy event. This is incorrect, as it misattributes a standard recovery sign to surgical preparation, unlike the nurse’s correct interpretation of expected bowel function.

Choice A reason: Tea, especially caffeinated, relaxes the lower esophageal sphincter, worsening GERD symptoms. Avoiding it shows understanding, making this a correct food the nurse would expect the client to avoid based on dietary education to prevent GERD exacerbation.

Choice B reason: Beer, an alcoholic beverage, irritates the esophagus and relaxes the sphincter, triggering GERD symptoms. Avoiding it reflects correct understanding, making this a correct food the nurse would include in teaching for the client to prevent GERD flare-ups.

Choice C reason: Cheese, while high-fat, is less likely to trigger GERD than alcohol or chocolate. Oatmeal is GERD-friendly, making this incorrect, as it’s not a primary trigger compared to the nurse’s teaching on foods to avoid for GERD symptom management.

Choice D reason: Oatmeal is a bland, high-fiber food that soothes GERD symptoms, not exacerbating them. Avoiding chocolate is correct, making this incorrect, as it’s a beneficial food, unlike the triggers the nurse teaches the client to avoid in GERD management.

Choice E reason: Chocolate contains caffeine and fat, relaxing the esophageal sphincter and worsening GERD. Avoiding it shows understanding, making this a correct food the nurse would expect the client to avoid to prevent symptom exacerbation based on GERD dietary teaching.

Choice F reason: Sweet potatoes are low-fat and non-irritating, not triggering GERD symptoms. Avoiding alcohol is correct, making this incorrect, as it’s a safe food, unlike the nurse’s teaching on foods the client should avoid to manage GERD effectively.

Choice G reason: Alcohol, including beer, relaxes the esophageal sphincter and irritates the mucosa, exacerbating GERD. Avoiding it reflects understanding, making this a correct food the nurse would include in teaching for the client to prevent GERD symptom flare-ups.

Choice H reason: French fries, high in fat, delay gastric emptying and worsen GERD symptoms. Avoiding them shows understanding, making this a correct food the nurse would expect the client to avoid based on dietary education to manage GERD effectively.