A nurse is contributing to the plan of care for a client who has a gastrostomy tube through which he is receiving continuous enteral feedings. Which of the following interventions should the nurse include in the plan?

Keep the head of the bed elevated at 15 degrees.

Place enough formula in the feeding bag to last for 8 hr of continuous feeding

Flush the tube with 30 ml of water every 4 hr.

Change the feeding bag and tubing every 72 hr.

Answer and Explanation

The Correct Answer is C

A. Keep the head of the bed elevated at 15 degrees.

This is not sufficient for preventing aspiration and ensuring proper digestion. The head of the bed should be elevated at least 30 degrees to reduce the risk of aspiration and promote better digestion of enteral feedings.

B. Place enough formula in the feeding bag to last for 8 hr of continuous feeding: It is recommended to change the feeding formula and bag every 24 hours. Placing formula for an extended period can increase the risk of bacterial growth.

C. Flush the tube with 30 ml of water every 4 hr: Regular flushing of the tube helps maintain patency, prevents clogging, and ensures proper hydration. Flushing every 4 hours is a standard practice for continuous feeding.

D. Change the feeding bag and tubing every 72 hr: Feeding bags and tubing should be changed more frequently, typically every 24 hours, to reduce the risk of infection.

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Correct Answer is C

Explanation

A. Assume position with legs and rectum lower than the stomach.

Explanation: This position helps gas move through the intestines more effectively, relieving abdominal distension and promoting the passage of flatus. It's a commonly recommended position for patients experiencing discomfort due to abdominal gas.
B. Drink cold liquids.

Explanation: Drinking cold liquids might not directly help with abdominal distension and flatus. Warm liquids, on the other hand, can sometimes promote digestion and relieve gas discomfort.
C. Ambulate several times a day.

Explanation: Ambulation or walking encourages movement in the intestines, aiding in the passage of gas. It also promotes overall bowel function and can help prevent postoperative complications like atelectasis and deep vein thrombosis.
D. Use a straw.

Explanation: Using a straw doesn't have a direct impact on relieving abdominal distension or flatus. It's more relevant for patients who might have difficulty drinking directly from a glass due to medical conditions or after certain types of surgeries

A. "I will take the medication for diarrhea." B. "I will have soft stools 1 to 3 days after starting this medication." C. "I will drink one half glass of water when I take the medication." D. "I can take this medication with mineral oil."

Correct Answer is B

Explanation

A. "I will take the medication for diarrhea."
This statement is incorrect. Docusate sodium is not used to treat diarrhea; it is a stool softener used to relieve constipation.

B. "I will have soft stools 1 to 3 days after starting this medication."

This statement indicates that the client understands the purpose of docusate sodium, which is a stool softener used to prevent constipation and to soften stool. It typically takes 1 to 3 days for the medication to produce the desired effect of softer stools.

C. "I will drink one half glass of water when I take the medication."
This statement is partially correct. Taking docusate sodium with a full glass of water is recommended, not half a glass, to ensure that the medication is properly absorbed and to prevent throat irritation.

D. "I can take this medication with mineral oil."
This statement is incorrect. Docusate sodium should not be taken with mineral oil because it can increase the absorption of mineral oil, leading to systemic effects.

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A nurse is contributing to the plan of care for a client who has a gastrostomy tube through which he is receiving continuous enteral feedings. Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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