The nurse is assessing a patient's bowel sounds.
The nurse does not hear anything for 30 seconds.
How should the nurse document this finding?

Choice A rationale

NPO (nothing by mouth) until dysphagia subsides might be a temporary measure immediately following a stroke to prevent aspiration. However, prolonged NPO status can lead to malnutrition and dehydration. The plan of care should aim for the safest and most effective route for nutritional support as soon as feasible, considering the patient's swallowing ability.

Choice B rationale

Initiation of total parenteral nutrition (TPN) is a method of providing nutrition intravenously, bypassing the gastrointestinal tract. TPN is typically reserved for patients with a non-functional or severely impaired digestive system. For a patient with dysphagia after a stroke, if the gastrointestinal tract is functional, enteral feeding (via a feeding tube) is often preferred over TPN due to its physiological benefits and lower risk of complications.

Choice C rationale

A mechanical soft diet consists of foods that are easy to chew and swallow. The texture of the food is altered (e.g., pureed, mashed, ground) to reduce the effort required for mastication and swallowing, thereby decreasing the risk of aspiration in patients with dysphagia. This type of diet is a common nutritional therapy for individuals with mild to moderate swallowing difficulties following a stroke.

Choice D rationale

Supplements via NG tube (nasogastric tube) involve delivering liquid nutritional formulas directly into the stomach through a tube inserted into the nose and down the esophagus. While an NG tube can provide necessary nutrition for patients with dysphagia, a gastrostomy tube (G-tube or PEG tube), placed directly into the stomach through the abdominal wall, is often preferred for long-term enteral feeding as it is generally more comfortable and less likely to cause irritation than an NG tube.

Choice A rationale

Canned tuna and salmon, while sources of protein and omega-3 fatty acids, are not particularly high in potassium. Clients taking potassium-wasting diuretics need foods rich in potassium to replace the electrolytes lost through increased urination.

Choice B rationale

Oranges and bananas are excellent sources of potassium. Potassium is an essential electrolyte that is often depleted by potassium-wasting diuretics like furosemide or hydrochlorothiazide. Consuming these fruits helps maintain adequate potassium levels, which are crucial for cardiac function and muscle contraction. The normal range for serum potassium is typically 3.5-5.0 mEq/L.

Choice C rationale

Dried fruits, such as apricots and raisins, are high in potassium. However, the question asks what the nurse *should* include, and while dried fruits are beneficial, fresh fruits like oranges and bananas are often more readily available and consumed in larger quantities.

Choice D rationale

Cow's milk contains potassium but is not specifically emphasized for clients on potassium-wasting diuretics. Other food sources like fruits and vegetables generally provide a more direct and often higher concentration of potassium without the added phosphorus and calcium found in milk, which may be considerations for some individuals.