A patient has been blind for several years because of complications with diabetes mellitus.
Which should the nurse do to assist this patient with meals?
Explain to the patient where items are located on the plate according to the hours on a clock.
Encourage eating one food at a time according to the preferences of the patient.
Order finger foods that are permitted on the patient's diet.
Feed the patient the prescribed meal.
The Correct Answer is A
Choice A rationale
Explaining the location of food items on the plate using the clock face analogy (e.g., "your meat is at 12 o'clock, your vegetables are at 3 o'clock") provides a consistent and easily understandable spatial reference for a visually impaired patient. This method allows the patient to independently locate and access different food items, promoting autonomy during meals.
Choice B rationale
Encouraging eating one food at a time based on preference does not directly address the challenge of navigating the plate when blind. While respecting preferences is important, it doesn't provide a systematic way for the patient to know where each food item is located.
Choice C rationale
Ordering finger foods might seem helpful, but it limits the variety and nutritional balance of the patient's diet. Not all foods can be easily eaten with fingers, and this approach does not promote independence in eating a regular meal.
Choice D rationale
Feeding the patient completely removes their independence and can be disempowering. The goal is to assist the patient in maintaining as much autonomy as possible, and explaining food placement allows them to eat independently.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
Choice A rationale
Vanilla pudding is often restricted in dysphagia diets due to its smooth, slippery texture, which can be difficult to control in the oral cavity and increases the risk of aspiration into the airway. Individuals with dysphagia may have impaired swallowing mechanisms, making thin, liquid-like consistencies particularly hazardous.
Choice B rationale
Cranberry juice is a thin liquid and poses a significant aspiration risk for a patient with dysphagia. Thin liquids are difficult to manage in the mouth and throat, increasing the likelihood of the liquid entering the trachea instead of the esophagus. Patients with swallowing difficulties often require thickened liquids to improve bolus control.
Choice C rationale
Beef broth is a clear liquid and, similar to cranberry juice, presents a high risk of aspiration for a patient with dysphagia. Its thin consistency makes it challenging for individuals with impaired swallowing to control its movement, potentially leading to it entering the airway and causing respiratory complications.
Choice D rationale
Orange gelatin, while seemingly semi-solid, often melts into a thin liquid in the mouth due to body temperature. This change in consistency makes it difficult to control and increases the risk of aspiration in patients with dysphagia. Gelatin's slippery texture further compounds this risk.
Correct Answer is C
Explanation
Choice A rationale
While it is important to inform the physician about the delay in the TPN solution, the immediate priority is to maintain the patency of the central venous catheter and prevent hypoglycemia. Calling the MD should occur after taking steps to address the immediate risk.
Choice B rationale
Giving the patient a high-protein snack will not address the immediate issue of the TPN running out and the risk of hypoglycemia associated with the abrupt cessation of a high-glucose solution. TPN provides a significant amount of glucose, and suddenly stopping it can lead to a drop in blood sugar.
Choice C rationale
Hanging a bag of 10% dextrose solution (D10W) is the most appropriate immediate action. This will provide a continuous source of glucose to prevent hypoglycemia while waiting for the new TPN bag from the pharmacy. D10W is often used as a bridge solution in this situation. Normal blood glucose levels are typically 70-110 mg/dL.
Choice D rationale
Flushing the line and waiting for the pharmacy to supply the next bag without infusing any solution puts the patient at significant risk for hypoglycemia and can also lead to catheter occlusion. Maintaining a continuous infusion, even of D10W, is crucial. .
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