A nurse is providing preoperative teaching to an older adult female client who is scheduled for a laminectomy and uses supplements. Which of the following supplements should the nurse identify as increasing the client's risk for hypotension during surgery?

A. Flush the tubing with 30 mL of water every 4 hr. Flushing the tube regularly helps maintain patency, prevent clogging, and ensure that the feeding is delivered effectively. This is a standard practice in managing enteral feeding systems.
B. Check for gastric residual every 12 hr. Gastric residuals should typically be checked every 4 to 6 hours, or per facility protocol, especially in clients at risk for aspiration. Waiting 12 hours is too long and may delay identifying feeding intolerance.
C. Place enough formula in the container to last 18 hr. Open systems should have fresh formula added every 4 hours to reduce the risk of bacterial contamination. Leaving formula in the feeding bag for 18 hours exceeds safety guidelines and increases infection risk.
D. Maintain bed elevation at 20°. The head of the bed should be elevated to at least 30 to 45 degrees to reduce the risk of aspiration. A 20° elevation is insufficient and does not provide adequate protection during feeding.

A. Request an interpreter of a different sex from the client. The interpreter's sex should be based on the client’s cultural preferences, not assumed by the nurse. This decision should be made to promote comfort and cultural sensitivity.
B. Request a family member or friend to interpret information for the client. This is not recommended, especially for medical discussions, as it may lead to misinterpretation, breaches of confidentiality, and biased communication.
C. Direct attention toward the interpreter when speaking to the client. The nurse should speak directly to the client, not the interpreter, to maintain a therapeutic relationship and respect for the client.
D. Review the facility policy about the use of an interpreter. This is the most appropriate initial action. Each facility typically has specific guidelines and procedures for accessing qualified medical interpreters, which the nurse should follow to ensure accurate and ethical communication.