A nurse is assessing a client who is receiving enteral feedings via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?

Switch to a lactose-free formula.

Reposition the NG tube.

Increase the rate of formula delivery.

Add water to the formula.

Answer and Explanation

The Correct Answer is D

A. Switch to a lactose-free formula – A lactose-free formula is necessary for clients with lactose intolerance but does not address the issue of hyperosmolar dehydration, which results from insufficient free water intake rather than intolerance to lactose.

B. Reposition the NG tube – Repositioning the tube is necessary if there is displacement, but it does not treat dehydration caused by hyperosmolar feedings.

C. Increase the rate of formula delivery – Increasing the rate can worsen dehydration by further increasing the solute load, leading to a greater fluid shift from intracellular to extracellular spaces.

D. Add water to the formula – This is the correct answer because hyperosmolar dehydration occurs when high-solute enteral formulas pull water into the intestines, leading to excessive fluid loss. To prevent this, the nurse should ensure the client receives adequate free water flushes alongside tube feedings.

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Correct Answer is D

Explanation

A. Place the client in Trendelenburg position during the procedure – Incorrect, as amniocentesis is typically performed with the client in a supine position.

B. Instruct the client to maintain a full bladder for the procedure – This is required for an early pregnancy amniocentesis (before 20 weeks), but for later procedures, the bladder should be empty.

C. Administer a tocolytic 30 min before the procedure – Not routinely necessary unless the client is at risk for preterm labor.

D. Monitor the fetal heart rate throughout the procedure – Correct, as amniocentesis carries a risk of fetal distress, and continuous monitoring ensures immediate detection of complications.

Correct Answer is ["2250"]

Explanation

To calculate the total volume of IV fluid intake, we need to calculate the volume administered during each time period and then sum them up.

First 3 hours: 500 mL/hr * 3 hr = 1500 mL

Next 3 hours: 200 mL/hr * 3 hr = 600 mL

Last 2 hours: 75 mL/hr * 2 hr = 150 mL

Now, we add these volumes together:

1500 mL + 600 mL + 150 mL = 2250 mL

Therefore, the total volume the nurse should document for the client's IV fluid intake is 2250 mL.

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A nurse is assessing a client who is receiving enteral feedings via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client prior to an amniocentesis. Which of the following actions should the nurse include in the plan of care?

Correct Answer is D

Explanation

Correct Answer is ["2250"]

Explanation

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