A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?

A. It reflects a desire to improve physical fitness, which is a common and generally positive goal. However, if this statement were accompanied by an excessive focus on weight loss or extreme measures to achieve fitness, it could indicate a problem, but on its own, this statement is not clearly indicative of cognitive distortion.
B. It reflects "all-or-nothing thinking," a common cognitive distortion in eating disorders. This pattern of thinking involves seeing things in black and white, where a small lapse in diet is perceived as a complete failure, leading to excessive and irrational behavior, such as consuming more than intended.
C. It shows a strong fear of gaining weight, which is typical in anorexia nervosa. However, it is more a sign of extreme concern about body image rather than a specific cognitive distortion pattern. Cognitive distortions often involve faulty logic or irrational beliefs, and this statement is more about an emotional response to weight gain.
D. Cutting food into small pieces can be a behavioral characteristic or ritual for someone with anorexia nervosa, but it does not necessarily reflect a cognitive distortion on its own. It might be a way to control portions or prolong the eating process, but it is not a direct example of distorted thinking.

A. Before administering an enteral feeding, it's important to discard any residual gastric contents to prevent aspiration. Aspirating and discarding the residual helps to assess gastric emptying and ensure that the stomach is able to tolerate the feeding.
B. While placing the client in a semi-Fowler's position is generally recommended during and after enteral feedings to help prevent aspiration, it's not necessary prior to administering the feeding.
C. Warming the feeding solution to body temperature can help to improve the client's comfort and may reduce nausea. However, it's not a critical step before administering the feeding.
D. Testing the pH of gastric aspirate is important to assess for gastric placement and to ensure that the tube is not in the lungs. However, it's typically done prior to the initial placement of the NG tube and is not routinely repeated before each feeding.