A nurse is contributing to the plan of care of a client who has had a stroke and is experiencing severe dysphagia with choking and coughing while eating.
Which of the following nutritional therapies should the nurse expect to include in the plan of care?
NPO until dysphagia subsides.
Initiation of total parenteral nutrition.
Mechanical soft diet.
Supplements via NG tube.
The Correct Answer is D
Choice A rationale
NPO (nothing by mouth) might be a temporary measure immediately following a stroke if aspiration risk is very high. However, prolonged NPO can lead to malnutrition and dehydration, hindering recovery. Nutritional support is crucial for stroke patients, so alternative feeding methods should be explored.
Choice B rationale
Total parenteral nutrition (TPN) is a method of providing nutrients intravenously, bypassing the gastrointestinal tract. It is usually reserved for patients with severe gastrointestinal dysfunction or when enteral feeding is not feasible or tolerated. While it provides nutrition, it carries risks of infection and metabolic complications and is not the first-line treatment for dysphagia.
Choice C rationale
A mechanical soft diet consists of foods that are easy to chew and swallow, reducing the risk of choking and aspiration in patients with mild to moderate dysphagia. This diet provides necessary nutrients while minimizing the effort required for safe oral intake, promoting better nutrition and hydration compared to NPO.
Choice D rationale
Supplements via NG tube provide enteral nutrition directly into the stomach or small intestine, bypassing the oral cavity and pharynx. This is an appropriate nutritional therapy for patients with severe dysphagia who cannot safely swallow even modified textures, ensuring adequate caloric and nutrient intake to support recovery and prevent malnutrition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Canned pineapple, while containing some fiber, typically has a lower fiber content compared to fresh fruits, especially when the skin is removed. The canning process can also reduce the fiber content. A diet rich in fiber promotes bowel regularity, helps control blood sugar levels, and can contribute to lower cholesterol.
Choice B rationale
Mashed potatoes, particularly if made with peeled potatoes, are relatively low in dietary fiber. Most of the fiber in a potato is found in its skin. Fiber is essential for maintaining healthy bowel function, preventing constipation, and contributing to feelings of fullness, which can aid in weight management.
Choice C rationale
Celery is a source of dietary fiber, primarily in its strings. Fiber adds bulk to the stool, facilitating its passage through the digestive system and preventing constipation. Adequate fiber intake is also associated with a reduced risk of cardiovascular disease and certain types of cancer.
Choice D rationale
Pears with skin are an excellent source of dietary fiber. The skin of fruits and vegetables is often rich in fiber. Dietary fiber plays a vital role in digestive health by promoting regularity, preventing constipation, and supporting the growth of beneficial gut bacteria. It also helps regulate blood sugar and cholesterol levels.
Correct Answer is B
Explanation
Choice A rationale
While a sudden and significant asymmetry in breast size or shape could indicate a new issue such as inflammation or a growth and warrants investigation, a slight, long-standing asymmetry is quite common among women. It does not automatically signify a pathological condition.
Choice B rationale
It is a well-established fact that many women have some degree of natural asymmetry in their breast size and shape. However, it is crucial for the nurse to ascertain if this finding is new for the patient. A recent change in asymmetry could be a sign of a developing condition that requires further evaluation.
Choice C rationale
While any new or significant asymmetry should be evaluated by a physician to rule out underlying issues, a long-standing, slight asymmetry is a common physiological variation and does not necessarily require immediate referral unless other concerning signs or symptoms are present.
Choice D rationale
Breastfeeding can sometimes cause temporary changes in breast size due to milk production and engorgement, and one breast might produce slightly more milk than the other. However, a noticeable and persistent asymmetry might predate breastfeeding or persist beyond it, and while it might be benign, attributing it solely to breastfeeding without further assessment of its history is not prudent. .
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