A nurse is reviewing the medical record of a client who has a stage 2 pressure injury. The nurse should identify that which of the following findings can impair the client's ability to heal?

A. "You are experiencing gastric retention due to total parenteral therapy.": Gastric retention is not a typical effect of TPN, which bypasses the gastrointestinal tract. Since nutrients are delivered directly into the bloodstream, it is unrelated to gastric motility or retention issues.
B. "You are not consuming enough dietary fiber.": Clients receiving total parenteral nutrition are usually not consuming food orally, so fiber intake is not relevant. Diarrhea in these clients is more likely linked to the composition or administration of the TPN solution.
C. "Your total parenteral therapy solution was too cold during administration.": Administering a cold TPN solution can irritate the gastrointestinal system and stimulate peristalsis, leading to diarrhea. Warming the solution to room temperature prior to administration can help prevent this adverse effect.
D. "You have had inadequate fluid intake.": TPN solutions contain fluids and electrolytes, and clients receiving them typically have carefully regulated intake. Dehydration is unlikely to be the cause of diarrhea in this context, and other factors should be considered first.

A. Feedings should begin within 1 hr after birth. Initiating feeding within the first hour of life supports early bonding and helps stabilize the newborn’s blood glucose. This applies to both breastfed and bottle-fed infants and is considered a key component of newborn care.
B. Feedings can be controlled by gravity. Bottle feedings should not rely solely on gravity, as this can increase the risk of overfeeding and aspiration. Instead, caregivers should hold the bottle at an angle and watch for feeding cues, allowing the infant to suck and swallow at their own pace.
C. Feedings should be on demand. While on-demand feeding is typically encouraged with breastfeeding, bottle feeding is generally guided by scheduled intervals (e.g., every 3–4 hours) early on. Over time, bottle-fed infants may show hunger cues, but structured timing helps regulate intake initially.
D. Feedings may occur in clusters. Cluster feeding is common with breastfeeding due to variable milk flow and infant comfort needs. Bottle-fed infants usually have more consistent feeding patterns and are less likely to feed in unpredictable clusters.