A nurse is assessing a child who is being treated for bacterial pneumonia. The nurse notes an increase in the child’s blood glucose. The nurse should identify this finding as an adverse effect of which of the following medication?

A. "Season foods with salt and pepper.": Spicy and seasoned foods can irritate the gastric mucosa, potentially worsening gastritis symptoms, so this advice is not appropriate.
B. "Eat small frequent meals daily.": Smaller, more frequent meals help reduce gastric acid secretion and minimize irritation of the stomach lining, which can alleviate symptoms of gastritis and promote healing.
C. "Use ibuprofen as needed for discomfort.": Nonsteroidal anti-inflammatory drugs like ibuprofen can exacerbate gastritis by irritating the stomach lining and increasing the risk of bleeding, so they should be avoided.
D. "Take a Vitamin E supplement daily.": There is no clear evidence supporting the use of vitamin E supplements for gastritis management, and supplementation is not a standard recommendation in this condition.

A. Maintain bed elevation at 20°: The head of the bed should be elevated to at least 30° to 45° during enteral feedings to reduce the risk of aspiration. A 20° angle is inadequate for preventing reflux and potential aspiration.
B. Flush the tubing with 30 ml of water every 4 hr: Routine flushing of the feeding tube helps maintain patency and prevent clogging. Flushing every 4 hours is standard practice for continuous feedings to ensure uninterrupted delivery.
C. Place enough formula in the container to last 18 hr: Open system formula should be discarded after 4 hours to reduce the risk of bacterial contamination. Filling the container for 18 hours exceeds safe hang time recommendations.
D. Check for gastric residual every 12 hr: Gastric residuals should typically be checked every 4 to 6 hours for continuous feedings, or per facility policy. Waiting 12 hours may delay the identification of feeding intolerance or complications.