A nurse is checking a client's bowel sounds.
At which of the following times should the nurse auscultate the client's abdomen?

Choice A rationale

Minimizing the use of seasoning can decrease palatability and potentially reduce the client's food intake, negatively impacting their nutritional status. Flavorful foods can stimulate appetite and encourage better nutrient consumption.

Choice B rationale

Limiting finger foods may restrict autonomy and reduce intake for clients who have difficulty using utensils. Finger foods can provide independence and increase caloric intake for some individuals in long-term care.

Choice C rationale

Serving small, frequent meals can improve nutritional intake by preventing early satiety and providing a consistent supply of nutrients throughout the day. This approach is often beneficial for individuals with decreased appetite or difficulty tolerating large meals.

Choice D rationale

Offering three large meals daily might be overwhelming for some clients in long-term care who may have reduced appetites, slower digestion, or other medical conditions that make it difficult to consume large quantities of food at once.

Choice A rationale

Sterile water is not the preferred solution for routine irrigation of a gastrostomy tube. Typically, tap water is recommended for irrigation in most home and long-term care settings for established PEG tubes, as it is cost-effective and generally safe. Sterile water is usually reserved for initial post-operative irrigation or in immunocompromised patients as per specific physician orders.

Choice B rationale

Keeping the head of the bed elevated at least 30 degrees is crucial for a client with a gastrostomy tube, especially one who has dysphagia and is at high risk for aspiration. Elevating the head of the bed helps to prevent reflux of stomach contents into the esophagus and subsequent aspiration into the lungs, reducing the risk of aspiration pneumonia. This position should be maintained during and after feedings and medication administration.

Choice C rationale

While maintaining oral hygiene is important for all patients, including those with gastrostomy tubes, moistening the client's lips with lemon glycerin swabs is generally discouraged. Lemon glycerin swabs can dry out the mucous membranes of the mouth and may not provide adequate hydration. Plain water or a moisturizing oral swab is a better choice for maintaining oral comfort.

Choice D rationale

Measuring the client's abdominal girth can be a useful assessment for detecting abdominal distension, which might indicate feeding intolerance or other complications related to the gastrostomy tube. However, it is not a primary intervention immediately following PEG tube placement. Ensuring proper positioning to prevent aspiration is a more critical initial intervention for a client with dysphagia.