Which older client with a feeding tube would the nurse identify as being at the highest risk of dehydration?

Question

1. The client's tube feeding totals 1,500 mL every 24 hours
2. Receiving 60 mL of water every 4 hours
3. Client has infrequent, loose stools
4. Receiving feedings with a formula that is 1.5 calories per mL

Answer 1

4. Receiving feedings with a formula that is 1.5 calories per mL

Explanation: 1. 1,500 mL of fluid intake is the minimum, with a 1 kcal/mL concentration, to prevent dehydration.
2. A client who is receiving 360 mL of free water daily could be at risk for dehydration, depending on the amount and type of tube feeding formula being used.
3. Stools are monitored for consistency and frequency. If the client develops diarrhea (frequent, liquid stools), the client can experience dehydration. Infrequent loose or liquid stools are common with tube feeding and can be addressed by offering feeding at room temperature, administering feedings in a drip rather than a bolus, or via other intervention.
4. Tube feeding formulas that are denser than 1 calorie per milliliter are hypertonic and predispose the client to dehydration unless the client also receives free water.