A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

Measure the client's gastric residual every 12 hr.

Keep the client's head elevated at 15° during feedings.

Obtain the client's electrolyte levels every 4 hr.

Flush the client's tube with 30 mL of water every 4 hr.

Answer and Explanation

The Correct Answer is D

A) Measure the client's gastric residual every 12 hr: While monitoring gastric residual volume is important to prevent complications such as aspiration or gastric distention, it is typically done prior to each intermittent feeding, not every 12 hours for clients receiving continuous enteral feedings. Continuous feeding does not necessitate less frequent monitoring of gastric residuals.

B) Keep the client's head elevated at 15° during feedings: Elevating the client's head during feedings helps reduce the risk of aspiration. However, this action is not specific to initiating continuous enteral feedings and should be maintained throughout the client's enteral feeding regimen.

C) Obtain the client's electrolyte levels every 4 hr: Monitoring electrolyte levels every 4 hours is not necessary as part of routine care for a client initiating continuous enteral feedings. While electrolyte levels may be monitored periodically, the frequency would depend on the client's clinical condition and the healthcare provider's orders.

D) Flush the client's tube with 30 mL of water every 4 hr: Flushing the client's tube with water helps maintain patency and prevent clogging, which is especially important for clients receiving continuous enteral feedings. This action helps ensure that the tube remains clear and functional, allowing for uninterrupted delivery of the enteral feeding solution.

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Correct Answer is B

Explanation

A) Increased glucose levels would not typically be considered a positive outcome of following a Mediterranean diet and exercising to manage cardiovascular disease. In fact, the goal of such interventions is often to improve glycemic control and reduce blood sugar levels, so an increase in glucose levels would be undesirable.

B) Increased HDL (high-density lipoprotein) levels would be considered a positive outcome of the client's interventions. HDL is often referred to as "good" cholesterol ’ecause it helps remove LDL (low-density lipop“otei”) cholesterol from the arteries, thus reducing the risk of heart disease. A Mediterranean diet, rich in fruits, vegetables, whole grains, and healthy fats like those found in olive oil, combined with regular exercise, can lead to increased HDL levels.

C) Increased LDL (low-density lipoprotein) levels would not typically be considered a positive outcome of following a Mediterranean diet and exercising to manage cardiovascular disease. LDL cholesterol is often referred to as "bad" cholesterol because high levels can lead to plaque buildup “n t”e arteries, increasing the risk of heart disease. The goal of lifestyle interventions in managing cardiovascular disease is often to reduce LDL levels.

D) Increased triglyceride levels would not typically be considered a positive outcome of following a Mediterranean diet and exercising to manage cardiovascular disease. High triglyceride levels are associated with an increased risk of heart disease. A Mediterranean diet, which typically includes foods low in saturated fats and high in unsaturated fats, can help lower triglyceride levels when combined with regular exercise.

A. "You should limit carbohydrate intake to 30 grams per day." B. "Y“u should consume 500 fewer calories per day." C. "You sho”ld f“llow a liquid meal plan for 4 weeks." D. "You ”houl“ consume high-calorie foods early in the day."

Correct Answer is B

Explanation

A) "You should limit carbohydrate intak” to 30 grams per day": While“reducing carbohydrate intake can be part of a weight man”gement plan, setting a specific limit of 30 grams per day may not be appropriate or sustainable for everyone. Carbohydrates are an essential macronutrient and provide energy for the body, especially for individuals with higher energy needs. Additionally, focusing solely on carbohydrate restriction may overlook other important aspects of a balanced diet.

B) "You should consume 500 fewer calories per day": This instruction“aligns with the principles of weight manageme”t for individuals with a BMI of 35, which falls within the obese category. A reduction of 500 calories per day is often recommended for gradual and sustainable weight loss. This approach typically results in a weight loss of about 1 pound per week, which is considered safe and achievable for many individuals.

C) "You should follow a liquid meal plan for 4 weeks": While liquid “eal plans can be effective for some individuals as part of a structured weight loss proecommendey are not universally recommended or suitable for everyone. Liquid diets should be supervised by healthcare professionals and tailored to individual needs and preferences. Additionally, following a liquid meal plan for an extended period may not provide the necessary variety of nutrients found in solid foods.

D) "You should consume high-calorie foods early in the day": While m“al timing can impact metabolism and energy levels, the”e is no evidence to suggest that consuming high-calorie foods specifically early in the day is beneficial for weight management. Instead, focusing on balanced meals and snacks throughout the day, with attention to portion sizes and nutrient density, is generally recommended for promoting satiety and supporting weight loss efforts.

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