A nurse is initiating an intermittent enteral feeding for a client who has a new gastrostomy tube. Which of the following actions should the nurse take first?

Elevate the head of the bed.

Attach the barrel of the syringe to the tube after removing the plunger.

Insert air into the tube before pulling back gastric contents.

Flush the tube with 30 mL water.

Answer and Explanation

The Correct Answer is A

A. Elevate the head of the bed: Raising the head of the bed to at least 30 to 45 degrees is the first and most essential action to reduce the risk of aspiration during enteral feeding. This position helps ensure that the formula flows into the stomach by gravity and minimizes the potential for reflux of gastric contents into the lungs, which can lead to aspiration pneumonia.
B. Attach the barrel of the syringe to the tube after removing the plunger: This step is necessary for gravity-based enteral feeding when using a syringe. However, it should only be done after confirming tube placement and ensuring the patient is positioned properly. Attaching the syringe before proper safety precautions increases the risk of aspiration.
C. Insert air into the tube before pulling back gastric contents: Injecting air into the gastrostomy tube is part of the verification process to confirm tube placement, often followed by aspirating gastric contents. While this is important, it is not the very first action. The client's head must be elevated first to ensure safety before any manipulation of the tube begins.
D. Flush the tube with 30 mL water: Flushing is necessary to ensure tube patency and to prevent blockage before and after feedings. However, it is not the first step in the procedure. Elevating the head of the bed comes before flushing to prevent aspiration during any subsequent feeding or fluid administration.

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Correct Answer is ["A","D","F","G"]

Explanation

A. "Small frequent snacks can help prevent a drop in glucose." Frequent, small meals help stabilize blood glucose levels and reduce the risk of nausea due to an empty stomach. They also promote consistent calorie intake when appetite is reduced during early pregnancy.
B. "Make sure to hydrate with your meals." Drinking fluids with meals can increase gastric fullness and make nausea worse. It's often better to drink fluids between meals to avoid bloating and help control symptoms.
C. "It is okay if you need to skip some meals." Skipping meals may lead to hypoglycemia, which can intensify nausea and fatigue. Maintaining a steady intake of food, even in small amounts, supports maternal and fetal well-being.
D. "Hard candy is an appropriate snack." Sucking on hard candy can help reduce nausea by stimulating saliva production and masking unpleasant tastes. It can also serve as a quick source of energy between meals.
E. "Consume large meals to provide adequate calories." Large meals may worsen nausea by distending the stomach. Smaller, frequent meals are better tolerated and still provide sufficient nutrition over the course of the day.
F. "Ginger tea may help settle your stomach." Ginger has been shown to reduce mild to moderate nausea during pregnancy. Ginger tea offers a safe and natural way to soothe the stomach without the use of medications.
G. "Eat crackers before getting out of bed in the morning." Eating bland foods like crackers before rising helps prevent an empty stomach, which often triggers morning sickness. This simple routine can reduce nausea on waking.

A. Administer antiemetics following the meal. B. Provide mouth care before feeding. C. Assess for pain prior to mealtime. D. Remove the bedpan from the client's sight. E. Discourage snacks between meals.

Correct Answer is ["B","C","D"]

Explanation

A. Administer antiemetics following the meal: Administering antiemetics after meals is not effective in preventing nausea or vomiting, which can interfere with nutritional intake. For clients at risk of malnutrition, the goal is to promote adequate food consumption, and antiemetics should be given before meals if nausea is anticipated.
B. Provide mouth care before feeding: Providing oral hygiene before meals helps enhance taste perception and appetite, especially in long-term care clients who may experience dry mouth or poor oral health. It also reduces the risk of aspiration pneumonia by clearing away bacterial buildup. This simple but effective step promotes comfort and nutritional intake.
C. Assess for pain prior to mealtime: Pain can suppress appetite and reduce the client's willingness or ability to eat. Addressing pain before meals improves comfort and allows the client to focus on eating rather than being distracted by discomfort. Proper pain management is a vital part of a nutrition care plan for clients at risk for malnutrition.
D. Remove the bedpan from the client's sight: Removing unpleasant stimuli, such as a used or visible bedpan, helps create a more appetizing and dignified mealtime environment. Visual and olfactory triggers can suppress appetite, especially in vulnerable clients. Ensuring a clean and pleasant atmosphere supports improved nutritional intake.
E. Discourage snacks between meals: Discouraging snacks between meals can limit caloric intake in clients who already have reduced appetite or food intake. For those at risk of malnutrition, encouraging frequent small meals and nutritious snacks can be more effective in meeting daily nutritional needs. Restricting snacks may contribute to further calorie deficits.

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A nurse is initiating an intermittent enteral feeding for a client who has a new gastrostomy tube. Which of the following actions should the nurse take first?

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Explanation

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Explanation

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