A nurse is caring for four clients receiving enteral tube ...

[clippers!]

A nurse is caring for four clients receiving enteral tube feedings. Which client should the nurse see first?
 
  a. Client with a blood glucose level of 138 mg/dL
  b. Client with foul-smelling diarrhea
  c. Client with a potassium level of 2.6 mEq/L
  d. Client with a sodium level of 138 mEq/L

Question 2

A nurse is caring for a client receiving enteral feedings through a Dobhoff tube. What action by the nurse is best to prevent hyperosmolarity?
 
  a. Administer free-water boluses.
  b. Change the client's formula. c.
  Dilute the client's formula. d.
  Slow the rate of infusion.

[owenfalvey]

Answer to Question 1

ANS: C
The potassium is critically low, perhaps due to hyperglycemia-induced hyperosmolarity. The nurse should see this client first. The blood glucose reading is high, but not extreme. The sodium is normal. The client with the diarrhea should be seen last to avoid cross-contamination.

Answer to Question 2

ANS: A
Proteins and sugar molecules in the enteral feeding product contribute to dehydration due to increased osmolarity. The nurse can administer free-water boluses after consulting with the provider on the appropriate amount and timing of the boluses, or per protocol. The client may not be able to switch formulas. Diluting the formula is not appropriate. Slowing the rate of the infusion will not address the problem.

[clippers!]

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