The patient has just been started on an enteral feeding and has ...

[Anajune7]

The patient has just been started on an enteral feeding and has developed diarrhea after being on the feeding for 2 hours. What does the nurse suspect is the most likely cause of the diarrhea?
 
  a. Antibiotic therapy
  b. Clostridium difficile
  c. Formula intolerance
  d. Bacterial contamination

Question 2

The patient is having at least 75 of nutritional needs met by enteral feeding, so the health care provider has ordered the parenteral nutrition (PN) to be discontinued. However, the nurse notices that the PN infusion has fallen behind.
 
  What should the nurse do?
  a. Increase the rate to get the volume caught up before discontinuing.
  b. Stop the infusion as ordered.
  c. Taper infusion gradually.
  d. Hang 5 dextrose.

[raenoj]

Answer to Question 1

ANS: C
Hyperosmolar formulas can cause diarrhea or formula intolerance. If that is the case, the solution is to lower the rate, dilute the formula, or change to an isotonic formula. Antibiotics destroy normal intestinal flora and disturb the internal ecology, allowing for Clostridium difficile toxin buildup. However, this takes time (more than 2 hours), and no indication suggests that this patient is on antibiotics. Bacterial contamination of the feeding usually occurs when feedings are left hanging for longer than 8 hours.

Answer to Question 2

ANS: C
Sudden discontinuation of PN can cause hypoglycemia. PN must be tapered off. Usually, 10 dextrose is infused when PN solution is suddenly discontinued. Too rapid administration of hypertonic dextrose (PN) can result in an osmotic diuresis and dehydration. If an infusion falls behind schedule, the nurse should not increase the rate in an attempt to catch up.

[Anajune7]

Excellent

[tkempin]

TYSM