Patients who are not able to meet their nutritional needs orally should be started on enteral nutrition within what time frame?
6-12 hours
12-24 hours
24-48 hours
5 days
The Correct Answer is C
A. 6–12 hours: Initiating enteral nutrition this early is typically reserved for critically ill patients who are hemodynamically stable and require immediate nutritional support. It is not the standard time frame for all patients unable to meet oral intake.
B. 12–24 hours: Early feeding within this window may be appropriate for certain high-risk critically ill patients, but standard practice generally recommends initiation within a slightly longer period for most patients.
C. 24–48 hours: Guidelines recommend starting enteral nutrition within 24–48 hours for patients who cannot meet nutritional needs orally. Early enteral feeding helps maintain gut integrity, prevent malnutrition, and reduce complications associated with prolonged fasting.
D. 5 days: Delaying enteral nutrition for several days increases the risk of malnutrition, impaired wound healing, and weakened immune response. Waiting this long is not recommended for patients who cannot meet caloric and protein needs orally.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. IV Dextrose 10% bolus: Administering dextrose can increase serum osmolality and potentially worsen cerebral edema. It is not indicated for reducing intracranial pressure. Dextrose is typically reserved for treating hypoglycemia.
B. Heparin infusion: Anticoagulation is not a primary intervention for elevated intracranial pressure. Heparin would be contraindicated in patients at risk of intracranial bleeding or cerebral edema.
C. Furosemide PO: Oral furosemide has a delayed onset and limited effectiveness in rapidly reducing intracranial pressure. While loop diuretics may be used adjunctively, IV administration is preferred for acute management.
D. IV Mannitol or hypertonic saline: Osmotic agents such as IV mannitol or hypertonic saline are first-line therapies for elevated ICP. They create an osmotic gradient that draws fluid from cerebral tissue into the intravascular space, reducing cerebral edema and pressure effectively and rapidly.
Correct Answer is C
Explanation
A. A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections: Starting insulin may improve glycemic control, but it does not directly increase the risk for hyperosmolar hyperglycemic syndrome (HHS). HHS usually develops in the context of uncontrolled hyperglycemia rather than new insulin therapy.
B. A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning: Missing insulin doses in type 1 diabetes is more likely to precipitate diabetic ketoacidosis (DKA) rather than HHS. DKA develops rapidly with ketone formation due to absolute insulin deficiency.
C. A 83-year-old long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza: HHS typically occurs in older adults with type 2 diabetes during periods of acute illness or stress, which can cause severe hyperglycemia, dehydration, and hyperosmolarity without significant ketosis. Infection such as influenza increases risk, making this patient the highest risk.
D. An 18-year-old college student with type 1 diabetes who exercises excessively: Excessive exercise may affect blood glucose levels but is more likely to cause hypoglycemia in type 1 diabetes rather than precipitate HHS, which occurs mainly in type 2 diabetes under stress or illness.
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