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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["236"]
Explanation
Identify the calorie content per gram of each macronutrient.
Protein: 4 calories/gram
Fat: 9 calories/gram
Carbohydrates: 4 calories/gram
Calculate the calories from protein.
Calories from protein = 2 g × 4 calories/gram
= 8 calories.
Calculate the calories from fat.
Calories from fat = 12 g × 9 calories/gram
= 108 calories.
Calculate the calories from carbohydrates.
Calories from carbohydrates = 30 g × 4 calories/gram
= 120 calories.
Calculate the total calories in the cookie.
Total calories = Calories from protein + Calories from fat + Calories from carbohydrates
= 8 calories + 108 calories + 120 calories
= 236 calories.
Rounded to the nearest whole number: 236.
Correct Answer is ["B","D","E"]
Explanation
A. Limit use of antiemetics until after first emesis: Antiemetics are more effective when administered prophylactically before the onset of nausea. Waiting until after emesis can reduce their effectiveness and worsen the client's discomfort and nutritional status.
B. Sit up for 1 hr after eating meals: Sitting upright for at least an hour after meals helps prevent gastric reflux and reduces the likelihood of nausea and vomiting. It also promotes digestion by allowing gravity to aid in the movement of food through the gastrointestinal tract, which can be especially beneficial for chemotherapy clients prone to delayed gastric emptying.
C. Eat foods low in carbohydrates: Carbohydrates, particularly simple ones like toast, rice, or crackers, are usually better tolerated during chemotherapy-induced nausea. Low-carbohydrate foods may be harder to digest and may not provide the quick energy or stomach-soothing effect that simple carbs do.
D. Sip fluids shyly throughout the day: Sipping fluids slowly throughout the day helps maintain hydration while avoiding the discomfort and nausea that can come from drinking large amounts at once. It also prevents dehydration, a common complication of chemotherapy. Gradual fluid intake is easier to tolerate and supports overall gastrointestinal comfort.
E. Consume foods that are served cold: Cold foods are generally better tolerated than hot or heavily seasoned ones during chemotherapy treatment. Hot foods can have strong odors that trigger nausea, while cold foods are often milder in smell and taste. Offering cold meals like yogurt, chilled fruits, or cold sandwiches can help reduce nausea severity.
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