A nurse is caring for a client who is at high risk for developing diabetes insipidus (DI) following a severe head injury. Which assessment finding indicates to the nurse that the client is developing DI?

A. Banana slices: Soft, ripe bananas are easy for toddlers to chew and swallow, making them a safe option that minimizes the risk of choking and aspiration. Cutting the fruit into small, manageable pieces further reduces the risk and aligns with recommended feeding practices for young children.

B. Popcorn: Popcorn is a high-risk food for toddlers due to its small, hard, and irregular pieces that can easily lodge in the airway. It should be avoided in young children to prevent choking and aspiration hazards.

C. Hot dogs: Whole or large pieces of hot dogs are a major choking risk for toddlers because they are firm, slippery, and can block the airway. If served, they should be cut into very small, lengthwise pieces, but they are generally not recommended for very young children.

D. Seeded grapes: Grapes with seeds are hard and round, posing a significant aspiration risk for toddlers. Seeds increase the likelihood of airway obstruction, making this food unsafe for young children without proper modification.

A. Gastric content pH: The pH of the gastric aspirate increased from 4.8 to 6.4, which may indicate a change in gastric emptying or possible contamination with intestinal contents. However, a pH of 6.4 alone is not an immediate reason to hold enteral feeding unless accompanied by other concerning signs.

B. Abdominal findings: The client has a distended, firm, and tense abdomen, which may indicate intolerance to the tube feeding, delayed gastric emptying, or possible bowel obstruction. These physical findings require immediate attention because continuing enteral feeding could worsen complications such as vomiting, aspiration, or bowel perforation.

C. Oxygen saturation: The client’s oxygen saturation is 96% on room air, which is within normal limits. While hypoxia can be a sign of aspiration or respiratory compromise, the current oxygenation does not indicate an immediate need to hold feeding or notify the provider.

D. Gastric residual: A residual volume of 90 mL with a pH of 6.4 suggests delayed gastric emptying or intolerance of the feeding. High residuals increase the risk of aspiration and indicate that the client may not tolerate additional enteral nutrition. Holding the feeding and notifying the provider is warranted to prevent complications.

E. Blood glucose: The client’s blood glucose is slightly elevated at 152 mg/dL, which falls within the range for administering correctional insulin per provider orders. Although ongoing monitoring is important, this glucose level does not require holding the feeding.

F. Laboratory electrolyte levels: The client’s potassium (3.7 mEq/L) and sodium (137 mEq/L) are within normal limits. There are no electrolyte abnormalities that would necessitate holding the tube feeding at this time, though continued monitoring is important for ongoing nutritional support.