The nurse is evaluating the intake data.

Click to highlight the findings that require a priority follow-up.

A 42-year-old female client presents to the emergency department experiencing indigestion, pain when swallowing, and aching pain in the middle upper abdomen. Additionally, the client is experiencing nausea and had one episode of emesis prior to arrival. Reports that the pain began shortly after she finished breakfast, but this is not the first time this has happened. She informs previous symptoms started 6 months ago with episodes occurring 1 to 2 times per month, but now symptoms occur multiple times per day. Has tried drinking milk which originally helped symptoms but no longer provides any relief. Was diagnosed with type 2 diabetes last year and takes metformin. She informs that she smokes 1 pack of cigarettes per week.

A. 1,360 – Too small; likely represents a miscalculation.
B. 70,720 – Represents only productive hours, does not include nonproductive time.
C. 141,440 – Correct total hours including both productive and nonproductive time. To calculate the total hours of productive and nonproductive time for the unit annually, use the formula: Total hours = Number of FTEs × hours per FTE per year. A standard FTE is typically based on 40 hours per week for 52 weeks, which equals 2,080 hours per year. calculation: Number of FTEs = 34. Hours per FTE per year = 40 × 52 = 2,080 hours. Total hours = 34 × 2,080. Calculate: 34 × 2,000 = 68,000. 34 × 80 = 2,720. Add them together: 68,000 + 2,720 = 70,720. This 70,720 hours represents productive time. To account for both productive and nonproductive time (which includes vacation, sick leave, holidays, and training), the total hours are usually doubled, because nonproductive time roughly equals productive time. 70,720 × 2 = 141,440 hours. Therefore, the unit is accountable for 141,440 hours annually.
D. 20,720 – Too small; not relevant to this calculation.

A. Infants with heart failure and failure to thrive require structured, energy-efficient feeding schedules rather than feeding on demand. Feeding on demand may lead to missed caloric goals and increased fatigue, as these infants often lack the energy reserves to signal hunger consistently.

B. Infants with heart failure tire easily due to increased metabolic demands and decreased cardiac efficiency. Ensuring the infant is rested before feeding helps conserve energy, allowing for more effective feeding and improved caloric intake.

C. Because of fatigue and poor endurance, these infants may sleep through feeding times and fail to meet nutritional needs. Waking the infant ensures adequate caloric intake and supports weight gain, which is critical in failure to thrive.

D. Prolonged feeding times increase energy expenditure, leading to more calorie loss than gain. Feeds should generally be limited to about 20–30 minutes to prevent fatigue and optimize energy conservation.

E. A structured feeding schedule (e.g., every 3 hours) ensures consistent caloric intake while allowing for rest periods. This approach helps balance nutritional needs with the infant’s limited energy reserves.

F. Increasing caloric density (e.g., from standard to 24–28 cal/oz) allows the infant to receive more calories in smaller volumes, which is essential for infants with fluid restrictions and fatigue. Gradual increases help prevent gastrointestinal intolerance.

G. Stimulating the rooting reflex by stroking the cheek promotes effective sucking and feeding, especially in infants who are fatigued or have weak feeding efforts. This helps maximize intake during limited feeding time.

H. A PEG tube is not a first-line intervention for this infant. Enteral tube feeding may be considered if oral intake is inadequate, but typically nasogastric (NG) feeding is used initially. PEG placement is invasive and reserved for long-term feeding issues.