A nurse is caring for a client who has stomatitis following radiation therapy. Which of the following is an appropriate intervention for the nurse to take?

Serve foods without sauces or gravies.

Instruct the client to drink liquids without a straw.

Offer mouth rinses with normal saline and water.

Serve foods while still at a hot temperature.

Answer and Explanation

The Correct Answer is A

An appropriate intervention for a nurse caring for a client with stomatitis following radiation therapy would be to serve foods without sauces or gravies. Stomatitis is the inflammation of the mucous membranes in the mouth, which can cause pain and discomfort. Foods with sauces or gravies can irritate the affected areas and exacerbate the symptoms. Serving plain or bland foods can help alleviate discomfort and promote healing.

Instructing the client to drink liquids without a straw is not specifically related to stomatitis. The use of a straw may not have a direct impact on the condition. However, it is generally recommended to avoid using a straw when there are mouth sores or ulcers to prevent further irritation.

Serving foods while still at a hot temperature is not appropriate for a client with stomatitis. Hot foods can cause additional discomfort and may further irritate the inflamed tissues. It is advisable to serve foods at a cooler or lukewarm temperature to provide relief.

Offering mouth rinses with normal saline and water is not specifically related to stomatitis following radiation therapy. While mouth rinses can be helpful in maintaining oral hygiene and soothing oral tissues, the choice of rinse solution may vary depending on the client's condition and healthcare provider's recommendations. In some cases, a healthcare provider may prescribe a specific mouth rinse or provide instructions on the appropriate solution to use.

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Correct Answer is C

Explanation

Prednisone is a corticosteroid medication that is commonly prescribed for various conditions due to its anti-inflammatory and immunosuppressive effects. However, corticosteroids can impair wound healing by reducing the body's inflammatory response, delaying collagen synthesis, and weakening the tensile strength of the wound. This increases the risk of wound dehiscence, which is the separation or opening of surgical incisions.

Omeprazole is a proton pump inhibitor used to reduce stomach acid production and prevent gastric ulcers but does not directly affect wound healing or increase the risk of wound dehiscence.

Zolmitriptan is a medication used for the acute treatment of migraines and does not directly affect wound healing or increase the risk of wound dehiscence.

Verapamil is a calcium channel blocker used to treat high blood pressure and certain heart conditions. It does not directly affect wound healing or increase the risk of wound dehiscence.

A. Obtain the client's electrolyte levels every 4 hr. B. Keep the client's head elevated at 15° during feedings. C. Measure the client's gastric residual every 12 hr. D. Flush the client's tube with 30 mL of water every 4 hr.

Correct Answer is D

Explanation

A. Obtain the client's electrolyte levels every 4 hr.While monitoring electrolyte levels is important, obtaining them every 4 hours is excessive for a client who is stable and just starting enteral feedings. Typically, electrolyte levels are monitored based on clinical condition and provider orders.

B. Keep the client's head elevated at 15° during feedings.The client's head should be elevated at least 30 to 45 degrees during enteral feedings to reduce the risk of aspiration and improve gastric emptying. A position of only 15 degrees is insufficient for safety.

C. Measure the client's gastric residual every 12 hr.Gastric residuals should be assessed more frequently, especially in the initial stages of enteral feeding. It is typically recommended to check gastric residuals every 4 to 6 hours to ensure proper gastric emptying and tolerance to the feedings.

D. Flush the client's tube with 30 mL of water every 4 hr.Flushing the tube with water every 4 hours is a standard practice to maintain tube patency, prevent clogging, and ensure that the client receives adequate hydration.

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A nurse is caring for a client who has stomatitis following radiation therapy. Which of the following is an appropriate intervention for the nurse to take?

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