When assessing patient with nutritional needs, which patients will require follow-up from the nurse? (Select all that apply.)
a. A patient with infection taking tetracycline with milk
b. A patient with irritable bowel syndrome increasing fiber
c. A patient with diverticulitis following a high-fiber diet daily
d. A patient with an enteral feeding and 500 mL of gastric residual
e. A patient with dysphagia being referred to a speech-language pathologist
ANS: A, C, D
The nurse should follow up with the tetracycline, diverticulitis, and enteral feeding. Tetracycline has decreased drug absorption with milk and antacids and has decreased nutrient absorption of calcium from binding. Nutritional treatment for diverticulitis includes a moderate- or low-residue diet until the infection subsides. Afterward, prescribing a high-fiber diet for chronic diverticula problems ensues. A patient with a gastric residual volume of 500 mL needs to have the feeding withheld and reassessed for tolerance to feedings. All the rest are normal and expected and do not require follow-up. Patients manage irritable bowel syndrome by increasing fiber, reducing fat, avoiding large meals, and avoiding lactose or sorbitol-containing foods for susceptible individuals. Initiate consultation with a speech-language pathologist for swallowing exercises and techniques to improve swallowing and reduce risk of aspiration for a patient with dysphagia.
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