Which nursing intervention is likely to be most helpful in providing adequate nutrition while the client is recovering from a thermal burn injury?
A. Allowing the client to eat whenever he or she wants
B. Beginning parenteral nutrition high in calories
C. Limiting calories to 3000 kcal/day
D. Providing a low-protein, high-fat diet
Correct Answer: A. Allowing the client to eat whenever he or she wants.
Clients should request food whenever they think that they can eat, not just according to the hospital’s standard meal schedule. Ascertain food likes and dislikes. Encourage SO to bring food from home, as appropriate. This provides the patient or SO a sense of control; enhances participation in care and may improve intake.
Option B: Parenteral nutrition may be given as a last resort because it is invasive and can lead to infectious and metabolic complications. Total parenteral nutrition (TPN) maintains nutritional intake and meets metabolic needs in presence of severe complications or sustained esophageal or gastric injuries that do not permit enteral feedings.
Option C: Clients who can eat solid foods should ingest as many calories as possible. Appropriate guides to proper caloric intake include 25 kcal/kg body weight, plus 40 kcal per percentage of TBSA burn in the adult. As the burn wound heals, the percentage of burned areas is reevaluated to calculate prescribed dietary formulas, and appropriate adjustments are made.
Option D: The nurse needs to work with a nutritionist to provide a high-calorie, high-protein diet to help with wound healing. Refer to a dietitian or nutrition support team. This may be useful in establishing individual nutritional needs (based on weight and body surface area of injury) and identifying appropriate routes.
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