Nutrition and Fluid Balance Flashcards

Before initiating a tube feeding, the most reliable method the nurse should use to verify nasogastric tube placement is:

Answer: X-ray confirmation

X-ray (radiographic confirmation) is the gold standard for verifying nasogastric tube placement, especially before first use.

Total parenteral nutrition (TPN) must be administered through which type of access?

Answer: Central venous catheter

TPN is a hypertonic solution that causes phlebitis if given peripherally and must be administered via central venous access.

A patient receiving TPN is at greatest immediate risk for which complication?

Answer: Hyperglycemia

TPN solutions contain high concentrations of dextrose, making hyperglycemia the most common and immediately dangerous complication.

Refeeding syndrome is most likely to occur when nutrition is restarted in which type of patient?

Answer: Severely malnourished patient restarted on aggressive nutrition

Refeeding syndrome occurs in malnourished patients when carbohydrates are reintroduced, causing a sudden intracellular shift of phosphate, potassium, and magnesium.

What is the recommended head-of-bed elevation for a patient receiving continuous enteral tube feedings?

Answer: 30–45 degrees

Elevating the head of the bed 30–45 degrees during and for at least 30 minutes after tube feeding reduces aspiration risk.

The nurse checks gastric residual volume before a tube feeding and finds 280 mL. What is the most appropriate action?

Answer: Hold the feeding and notify the provider

A gastric residual over 250–500 mL (per facility policy) indicates delayed gastric emptying; the provider should be notified before continuing.

Which enteral formula modification is most appropriate for a patient with diabetes receiving tube feedings?

Answer: Low-carbohydrate, high-fiber, high-fat formula

Diabetes-specific formulas are lower in carbohydrates and higher in fat and fiber to reduce postprandial glucose spikes.