A nurse is teaching about denture care to the partner of a client who is unable to perform oral hygiene. Which of the following should the nurse include in the teaching?

Choice A reason: Administering the feeding by gravity drip is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Gravity drip can cause overfeeding, aspiration, and abdominal distension. The nurse should use an infusion pump to regulate the flow rate and volume of the feeding.

Choice B reason: Flushing the tubing with 10 mL water every 6 hr is an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Flushing the tubing prevents clogging, maintains patency, and hydrates the client. The nurse should also flush the tubing before and after medication administration, and whenever the feeding is interrupted or discontinued.

Choice C reason: Replacing the bag and tubing every 24 hr is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Replacing the bag and tubing every 24 hr does not prevent clogging, and may increase the risk of infection and contamination. The nurse should replace the bag and tubing every 48 hr, or as per facility policy.

Choice D reason: Heating the formula prior to infusion is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Heating the formula can alter its composition, reduce its nutritional value, and increase the risk of bacterial growth. The nurse should use room-temperature formula and store it in a refrigerator when not in use.

Choice A reason: Administering antiemetics following the meal is not an appropriate action for a client who is at risk for malnutrition. Antiemetics are medications that prevent or treat nausea and vomiting, which can interfere with oral intake and hydration. However, antiemetics should be given before the meal, not after, to reduce the likelihood of postprandial nausea and vomiting. ¹²

Choice B reason: Providing mouth care before feeding is an appropriate action for a client who is at risk for malnutrition. Mouth care can improve the client's appetite, taste, and comfort, as well as prevent oral infections and dental problems that can affect food intake. ³⁴

Choice C reason: Assessing for pain prior to mealtime is an appropriate action for a client who is at risk for malnutrition. Pain can reduce the client's appetite, mood, and ability to eat comfortably. The nurse should assess the client's pain level and provide adequate pain relief before offering food. ⁵⁶

Choice D reason: Removing the bedpan from the client's sight is an appropriate action for a client who is at risk for malnutrition. The presence of a bedpan or other unpleasant stimuli can cause the client to lose appetite, feel nauseated, or associate food with negative emotions. The nurse should create a pleasant and comfortable environment for the client to eat. ⁷⁸

Choice E reason: Discouraging snacks between meals is not an appropriate action for a client who is at risk for malnutrition. Snacks can provide additional calories, protein, and micronutrients that the client may not get from regular meals. Snacks can also help prevent hunger, fatigue, and hypoglycemia between meals. The nurse should encourage the client to have healthy snacks that are high in energy and nutrient density.