33: Nutrition

After a visit with the health care provider, the nurse calculates the client's body mass index (BMI). Which statement by the nurse best informs the client of the purpose of BMI?

"BMI is used to screen for weight categories that can lead to health problems." BMI is a person's weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems, but it is not diagnostic of the body fatness or health of an individual. Insurance companies have weight charts and do not use BMI for screening. The BMI does not refer to the weight that makes a person feel more comfortable.

A client with diabetes mellitus must monitor carbohydrate intake. Which client statement requires nursing intervention?

"My favorite drink is coffee with sugar." Foods containing added sugar as a major ingredient tend to supply calories but few, if any, other nutrients. A client monitoring carbohydrate intake should be mindful of the intake of extra sugar. The other answer choices are appropriate for a client diagnosed with diabetes mellitus who is monitoring carbohydrate intake.

The nurse is educating a client taking furosemide for heart failure about eating foods that are rich in potassium. Which statement made by the client indicates that education was effective?

"When I take my medication, I will eat a banana or take it with a glass of orange juice." The client demonstrates that the teaching was effective by identifying bananas and orange juice as foods rich in potassium. The desired effect of the medication is to excrete sodium to avoid the accumulation of fluid in the lungs. To increase the amount of salt in the diet would be counterproductive. Dairy products such as milk and cheese are not potassium-rich foods. Eating small frequent meals versus three meals per day is irrelevant in increasing potassium level.

The nurse is conducting a client health history interview and notes the client is taking atorvastatin. This observation should prompt the nurse to ask the client which question first?

"When did you last have your cholesterol levels checked?" Atorvastatin is a commonly prescribed HMO-COA reductase inhibitor. This classification of medication is taken to reduced blood cholesterol levels. It would be relevant to this observation for the nurse to follow with a question about the last time the client had serum triglyceride levels assessed to determine efficacy of the medication. Carbohydrates are not known to have a direct effect on increasing serum cholesterol levels. While it is important for the nurse to understand the client's nutritional intake and habits, this question would not be prioritized after noting that the client has this medication listed in the drug profile. Multivitamins provide supplementation for vitamin deficiencies but do not have a direct impact on a client's serum cholesterol levels. Overall, vegetarians have a lower incidence of colorectal cancer and fewer problems with obesity and diseases associated with a high-fat diet. Although the nurse can certainly inquire about what type of diet the client habitually consumes, this question does not directly relate to the observation that an antitriglyceride medication is being taken by the client.

Which nutritional guideline should a nurse provide to a client who is entering the second trimester of her pregnancy?

"You'll need to eat more calories and to make sure you eat a balanced diet high in nutrients." Nutrient needs during pregnancy increase in order to support growth and maintain maternal homeostasis, particularly during the second and third trimesters. During the last two trimesters, women of normal weight need approximately 300 extra calories per day. Key nutrient needs include protein, calories, iron, folic acid, calcium, and iodine. It would be inaccurate to encourage the client to maximize calorie intake, take supplements, and emphasize organic foods.

An older adult client who has a BMI of 28.1 and gastroesophageal reflux disease (GERD) reports heartburn frequently. The nurse plans to teach the client how to manage and prevent heartburn. What information will the nurse include in the teaching for this client? Select all that apply.

- Do not use products that contain nicotine, such as tobacco and vaping devices. - Maintain a diet that is low in fat. - Plan a nutritious diet that will allow you to lose weight. When teaching a client who has GERD, the nurse will include the following information: no smoking, a diet low in fat, and lose weight. Nicotine in tobacco and vaping products lower esophageal sphincter pressure, allowing reflux of stomach contents into the esophagus. Fat in the diet delays emptying of the stomach and increases the likelihood of reflux. Being overweight (a BMI greater than 25) increases intra-abdominal pressure, pushing gastric contents into the esophagus. The client is instructed to raise the head of the bed 30 to 40 degrees. This means placing the legs of the head of the bed on blocks. Using two pillows causes a bend in the neck. Pillows do not raise the level of the esophagus. The client is also instructed to avoid eating before bedtime. Again, eating before bedtime allows for reflux. Alcohol relaxes the lower esophageal sphincter pressure and increases the production of gastric acid. Both of these physiologic actions allow for reflux.

A client is receiving a continuous tube feeding using a commercially prepared formula at home. The nurse would instruct the client's caregiver to use the formula within which time frame once the container is opened?

24hrs After opening a commercially prepared formula, the container should be sealed and stored in the refrigerator and used within 24 hours. Clients receiving continuous tube feedings should have gastric residuals checked every 4 to 6 hours.

A nurse administers a continuous tube feeding via an NG tube. The nurse must check for residual every:

4 to 6 hours. Check for residual before each feeding or every 4 to 6 hours during a continuous feeding, according to institutional policy. This is implemented to identify delayed gastric emptying. Research suggests continuing the feedings with residuals up to 400 mL. If greater than 400 mL, the nurse should confer with the physician or hold feedings according to agency policy.

The nurse calculates the intake of a client who received a bolus tube feeding of 250 ml. The nurse administered 60 ml of water prior to the feeding and 60 ml of water after the feeding. The nurse administered crushed medications in 45 ml of water. Calculate the amount of fluid, in milliliters, the client received. Record your answer using a whole number.

415 The nurse calculates fluid intake for a client who receives tube feedings to ensure adequate hydration and to avoid too much fluid at one time. 60 ml of water + 250 ml of tube feeding + 60 ml of water + 45 ml of crushed medications in water = 415 ml

The nurse is assessing clients for basal metabolic rate (BMR). Which client would the nurse suspect would have an increased BMR?

A client who has a fever A client who has a fever would have an increased BMR. The energy needs of the body are increased due to the client's fever. The BMR is decreased in an older adult client, a client who is fasting, and a client who is asleep.

At what period of life do nutrient needs stabilize?

Adulthood Nutrient needs change across the life span in relation to growth, development, activity, and age. Periods of intense growth and development (such as during infancy, adolescence, pregnancy and lactation) increase nutrient needs. Nutrient needs stabilize during adulthood.

A nurse documents a client's hemoglobin as 8 g/dL (80 g/L). What nutritional condition does this biochemical data signify?

Anemia If hemoglobin (normal = 12 to 18 g/dL; 120 to 180 g/L) is decreased, anemia is present. A increased hematocrit signifies dehydration. Malnutrition is related to serum albumin, blood urea nitrogen, and creatinine. Decreased serum albumin also signifies malabsorption.

The nurse is caring for a client who refuses most foods on the dietary tray. Which nursing intervention is appropriate?

Assess when client generally eats meals. There are many reasons a client may refuse food that is served. The nurse should assess for food preferences, when the client generally eats, whether the client has digestive concerns, and cultural beliefs about foods. Leaving the client alone to eat, or simply delegating feeding, does not encourage intake. The client does not need an appetite stimulant until a full assessment has been conducted and other interventions have been implemented.

A client who is receiving tube feedings has developed diarrhea. Which nursing intervention is appropriate?

Consult with the health care provider about using a milk-free formula. The nurse will consult with the health care provider about using a milk-free formula since milk can induce diarrhea. Other interventions do not address the problem of diarrhea.

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which action should the nurse perform with TPN?

Discard unused TPN every 24 hours. With TPN, any unused portion should be discarded every 24 hours. Vital signs with TPN should be checked every 4 hours. Blood glucose should be checked every 6 hours. If the client has a transparent dressing on the central venous access, it can be changed weekly.

Which intervention should the nurse take for a client who is receiving continuous tube feedings?

Elevate the head of the bed at least 30 to 45 degrees to prevent aspiration. An elevation of at least 30 to 45 degrees or higher in a client receiving tube feedings will prevent reflux and prevent aspiration. Positioning the client in the supine position for extended periods may lead to aspiration. There is no need to aspirate the contents of the client's stomach after feeding. Coughing and deep breathing do not prevent the tube from being dislodged.

The nurse caring for a client for several days has assessed that he has been eating poorly during his hospitalization. Which nursing measure should the nurse implement to assist the client in improving his nutritional intake?

Encourage his daughter to prepare food at home and bring it to the client. The nurse should solicit food preferences and encourage favorite foods from home, when possible. Be sure the foods look attractive and the eating area is free of odors, clutter, and distractions during mealtime. Provide small, frequent meals to avoid overwhelming the client with large amounts of food.

A client resides in a long-term care facility. Which nursing intervention would promote increased dietary intake?

Encourage the client to eat in the dining room. Encouraging the client to eat in the dining room will allow for socialization during meal time. This will have a positive effect on the amount of food consumed and provide enjoyment. Feeding the client in bed encourages isolation from other residents. Allowing the client to eat whenever they want does not support socialization. Discouraging the family is not recommended, as the family can provide support and be assistive to the client and their food needs.

Carbonated sodas (such as Coca-Cola) are effective to clear a clogged feeding tube.

False

A client has been prescribed a clear liquid diet. Which food or fluids should the nurse serve the client?

Gelatin desert, carbonated beverages, and apple juice Clear liquid diets contain only foods that are clear liquids at room or body temperature, such as gelatin, fat-free broth, bouillon, ice pops, clear juices, carbonated beverages, regular and decaffeinated coffee, and tea. A full liquid diet includes all fluids and foods that become liquid at room temperature. This would include ice cream, chocolate milk, and liquid dietary supplements. Solid food examples are desserts, egg substitutes, and hot cereals. High-calorie, high-protein supplements are considered full liquids.

A nurse is delivering meal trays to clients on the unit. One client has a fractured dominant arm which is in a sling. What is the first nursing action when bringing the tray into the client's room?

Identify the name of the client. When serving meal trays, the nurse first identifies the name of the client to ensure the client receives the correct meal tray. The nurse will then assist this client, who has limited mobility of the arm, in preparing the food by removing lids from the food items, opening cartons of fluids, and cutting food into bite-sized pieces.

A nurse is administering a prescribed dose of IV fluid to a young client with anorexia at the health care facility. Which information regarding contributing factors should the nurse include when educating the family?

Illness can contribute to anorexia. Anorexia can be caused by depression, gastrointestinal dysfunction, infections, illnesses, malignancies, and side effects of many medications. Anorexia results in decreased food intake. Poor nutrition, the client's age, and ADHD are not precursors to anorexia.

A nurse is caring for a visually impaired client. How should the nurse manage the feeding for this client?

Inform the client about what kind of food is being offered with each mouthful. It is important to inform visually impaired clients about the food in each mouthful, to help them eat properly. The importance of developing a rapport with the client is not specific to visually impaired clients. It is necessary to provide liquid or soft diets to clients who have missing teeth or have had recent oral surgery. When caring for clients who have difficulty chewing and swallowing food, the nurse must determine that the client has swallowed one portion of food before offering another.

A nurse is caring for a client with a wound infection. The dietician has prescribed a diet rich in vitamin A. The client asks the nurse, "Why do I need vitamin A?" The nurse integrates an understanding of which rationale as a major reason when responding to the client?

It helps maintain healthy epithelium. Vitamin A is important for maintenance of healthy epithelium, maintenance of normal vision (especially in dim light), promotion of normal skeletal and tooth development, and promotion of normal cellular proliferation. Vitamin D promotes mobilization of calcium and phosphorus from bone, renal reabsorption of calcium, normal mineralization of bone and cartilage, intestinal absorption of calcium, and maintenance of calcium extracellular fluid for normal muscle contraction.

A nurse is feeding a client. Which action will the nurse take?

Offer options of foods and for the order to be eaten. The loss of independence that comes with the inability to self-feed can be a severe blow to a person's self-esteem. Asking the client's preference regarding the order of items eaten can help maintain dignity while being fed. The nurse should be prepared to spend as much time with the client to assist with the entire meal to support self-worth for the client. Telling a client what the nurse will do does not promote self-esteem but identifies the nurse wanting to control the feeding. Although the meal can get messy, the nurse should never use the term "bib" but let the client know a clothing protector will be used.

The nurse is using a large syringe to administer an intermittent feeding to a client who has a nasogastric feeding tube. Which method should the nurse use to increase the flow rate of the formula?

Raise the height of the syringe. If using a syringe to administer an intermittent feeding, raise or lower the syringe to adjust flow rate by gravity.

A client with partial-thickness (second-degree) burns is encouraged to increase the proteins in the diet. Which food selection from the hospital menu indicates that the client understands how to choose foods high in protein?

Scrambled eggs with cheese Scrambled eggs with cheese is a food choice high in protein content. Egg and cheese are both proteins. Pasta is a carbohydrate, but the Alfredo sauce is made with milk or a milk base, which is protein. Cereal is a complex carbohydrate with a variety of fortified nutrients, and the milk is a protein/carbohydrate source. Bran muffin and jelly are both carbohydrate sources.

A nurse has just received a client's laboratory results and is reviewing them. Which finding should the nurse recognize as an indication of malnutrition or malabsorption?

Serum albumin 2.8 g/dL (28 g/L) Normal serum albumin is 3.3 to 5 g/dL (33 to 50 g/L). Decreased albumin indicates malnutrition or malabsorption. Decreased Hgb indicates anemia. Increased creatinine indicates dehydration. Increased Hct indicates dehydration.

The nurse is caring for a client who has dysphagia and is unable to eat independently. The nurse is preparing to assist the client in eating a meal. Which action is appropriate?

Speak to the client but limit the need for the client to respond verbally while chewing and swallowing. Clients who have dysphagia need to eat slowly and be continually observed for signs of aspiration.

A nurse observes that a client coughs and chokes when eating. What instructions should the nurse prepare for this client?

Tell the client to chew his food very thoroughly. The nurse should suggest that the client chew the food thoroughly and encourage repeated swallowing attempts. Preparing a liquid diet or restricting milk and beverages is not a solution for preventing choking during meals.

A client having a bowel surgery asks why being NPO after surgery is necessary. Which statement by the nurse best describes the reason?

To rest the gastrointestinal tract and promote healing Withholding food may be indicated in the following situations: to rest the gastrointestinal tract to promote healing, clear the gastrointestinal tract of contents before surgery or diagnostic procedures, prevent aspiration during surgery or in high-risk clients, give normal intestinal motility time to return, treat severe vomiting or diarrhea, and to treat medical problems, such as bowel obstruction or acute inflammation of the gastrointestinal tract. Withholding food does not cause gas to accumulate or increase the amount of mucus in the bowel.

The nurse has observed that a client's food intake has diminished in recent days. What intervention should the nurse perform in order to stimulate the client's appetite?

Try to ensure that the client's food is attractive and sufficiently warm. Food in the health care setting can often be unattractive and cool. Ensuring that it is appealing to the eyes and presented at the correct temperature can stimulate the client's appetite. Meals should be small and more frequent, not less frequent and larger. Supplements may be nutritionally necessary, but these do not act to increase the client's appetite.

A client is prescribed warfarin, an anticoagulant. When educating this client about potential diet and drug interactions, the nurse would caution the client about foods containing which nutrient?

Vitamin K Specific foods may interact with medications, altering the effectiveness of the drug. Vegetables high in vitamin K decrease the effectiveness of the commonly used anticoagulant warfarin. Calcium, potassium, and Vitamin C do not interact with warfarin.

What is the most reliable method for verifying the correct placement of a nasogastric tube?

a radiographic exam that can confirm position

A nurse is preparing an education plan for a client who is scheduled for a diagnostic procedure that requires a clear liquid diet the day before the procedure. When teaching the client about what he may consume, which foods would the nurse include? Select all that apply.

apple juice gelatin tea A clear liquid diet includes only liquids that lack residue, such as juices without pulp (apple, cranberry), tea, gelatin, soda pop, and clear broth. A full liquid diet includes all foods and fluids that become liquid at room temperature, such as ice cream. Pureed vegetables would be appropriate for a mechanical soft diet, often used for clients who have difficulty chewing.

The nurse is helping a client who eats a normal diet of 2000 calories daily to read a nutritional label on a box of cereal. Which nutrient does the nurse identify as appropriate for this client?

cholesterol less than 300 mg Daily values are calculated in percentages based on standards set for total fat, saturated fat, cholesterol, sodium, carbohydrate, and fiber in a 2000-cal diet. Total fat should be less than 65 g; saturated fat should be less than 20 g; cholesterol should be less than 300 mg; and sodium should be less than 2400 mg.

The physician has asked the nurse to prepare a list of laboratory tests needed to assess an obese client's daily fat intake. Which test would the nurse include on the list?

cholesterol level test The cholesterol test, along with triglyceride and lipoprotein levels, needs to be conducted to adjust the amount of fats an obese client consumes. Complete blood count, serum albumin, and transferrin level tests will not help in estimating the amount of fat the client eats. The complete blood count is done especially for the hemoglobin, hematocrit, and number of lymphocytes. The serum albumin and transferrin level tests indicate the protein status in the body.

The nurse is testing the blood glucose levels of a client with a history of diabetes. The nurse has performed hand hygiene, checked the order, informed the client and turned on the monitor. After removing a test strip from the vial, what action should the nurse perform next?

confirm that the strip and the meter share the same code. It is important to confirm that the code on the strip and the meter match. This should precede massaging and cleansing the client's finger or piercing the client's skin.

The nurse should begin the process of removing a client's nasogastric (NG) tube by:

confirming the physician's order to remove the tube. Prior to beginning the process of removing a client's NG tube, it is important to confirm that the relevant order has been written.

Upon assessing that a client's nasogastric tube is obstructed, what is the appropriate nursing action?

contact health care provider

The nurse is teaching a client about ways in which to reduce sodium in the diet. Which foods will the nurse recommend that the client avoid? Select all that apply.

cured ham table salt bacon Sodium is found in higher concentrations in table salt, bacon, and processed meats. The other choices do not have a high concentration of sodium.

A nurse is caring for a client who is reporting nausea. Which is a sign of nausea?

dizziness and perspiration Nausea usually precedes vomiting. It is associated with dizziness and perspiration. Impaired swallowing is associated with clients who have dysphagia and not typically nausea. Slow pulse rate is not a symptom of nausea. Emotional distress may or may not be related to the client's condition.

The nurse is admitting an unconscious client who was observed ingesting a handful of various pills by a family member. Which order should the nurse have the health care provider clarify?

insert 8F nasogastric tube This client needs stomach contents removed and needs a larger sized tube. A 36F to 40F tube would be more appropriate. Any particles in the stomach would clog the smaller tube as suction is applied. An 8F tube is more appropriate as a nasointestinal tube to provide gavage not lavage. The other orders are appropriate for this situation.

A clogged nasointestinal tube is not responding to the nurse's attempt of flushing with 50 mL of warm water. The health care provider orders the use of a solution containing pancreatic enzymes. Which action should the nurse take?

let the solution set in the tube of 30 minutes before attempting to flush again An option to unclog the gastric tube is to instill a fluid-activated pancreatic enzyme combined with 1/8 teaspoon of sodium bicarbonate followed by letting it dwell for 30 minutes before attempting to flush the tube again. This also requires a written order. The back and forth method would be more appropriate using warm water in the initial attempt to remove a clog. The other choices would be inappropriate and puts the client at risk for more complications.

A client has developed an abscess following abdominal surgery, and the client's food intake has been decreasing over the past 2 weeks. Which laboratory finding may suggest the need for nutritional support?

low prealbumin levels Prealbumin levels are a good indicator of a client's short-term nutritional status; decreased levels are suggestive of malnutrition. Protein in the client's urine, low blood sugars, and increased white blood cells are not necessarily indicative of malnutrition. Proteinuria is urine having an abnormal amount of protein. The condition is often a sign of kidney disease. Random blood sugar can be affected by food intake. White blood cells are indicative of infection.

While preparing clients for bedtime, the nurse finds the visiting family members affected the environment. Which action by a family member will make the nurse determine that the family needs additional teaching?

lowered head of bed to 15° of client with nasogastric feeding tube Individuals with nasogastric tubes should remain with the head of the bed at least 30 degrees due to increased risk of gastric reflux related to the dilation of the cardiac sphincter. This in turn greatly increases the risk of aspiration. The other actions should not be concerning because they would increase the safety of the client.

A client with influenza is prescribed a diet that is rich in fiber and carbohydrates. Which would the nurse incorporate into the education plan as a major reason for the high fiber diet?

maintenance of normal bowel elimination Dietary fiber is a minimal source of energy but plays an essential role in stimulating peristalsis and maintaining normal bowel elimination. Proteins have specific functions of producing hemoglobin for carrying oxygen to tissues, insulin for blood glucose regulations, and albumin for regulating osmotic pressure in the blood. Fats perform the important functions of energy storage of adipose tissue, vitamin absorption, and transport of fat-soluble vitamins A, D, E, and K.

A postmenopausal client wishes to increase the amount of vitamin D that she consumes to help keep her bones strong. Which food will the nurse recommend?

milk Milk contains vitamin D, which helps with the absorption of calcium and phosphorous. The other choices do not.

A 45-year-old client on the inpatient unit has just resumed eating a normal diet. The nurse checks a blood sugar with the morning labs and the result is 99.10 mg/dL (5.5 mmol/L). How would the nurse interpret this blood glucose?

normal Normal blood glucose is 80 to 110 mg/dL (4 to 7 mmol/L).

A nurse is working with a 45-year-old construction worker. The nurse obtains his height and weight and calculates that his BMI is 28. How would the nurse best classify James?

overweight A body mass index (BMI) between 25 and 29.9 is considered overweight.

A nurse is caring for a client who has a body mass index (BMI) of 26.5. Which category should the nurse understand this client would be placed in?

overweight A client with a BMI below 18.5 should be considered underweight. A client with a BMI of 18.5 to 24.9 is considered to be at a healthy weight. A client with a BMI of 25 to 29.9 is considered overweight; a client with a BMI of 30 or greater indicates obesity. A BMI greater than 40 is considered extreme obesity.

A nurse calculates the BMI of a client during a general survey as 26. Under which category would this client fall?

overweight This client has a BMI of 26, which falls in the category of overweight: 25.0 to 29.9. The other BMI values are: underweight, <18.5; normal, 18.5 to 24.9; obesity class I, 30.0 to 34.9; obesity class II, 35.0 to 39.9; and extreme obesity, 40.0+.

The nurse is helping a client, who wishes to increase Omega-3 fatty acids, to order breakfast. Which food will the nurse recommend?

salmon Omega-3 fatty acids are found in fish such as salmon, halibut, sardines, olive oil, flaxseed, walnuts, and certain types of legumes. The other food choices do not contain Omega-3 fatty acids.

A nurse is preparing a presentation for a local community group on healthy nutrition using information from the USDA's website, ChooseMyPlate.gov. Which recommendation would the nurse be least likely to include?

switching to whole milk According to the ChooseMyPlate.gov food guide, individuals should switch to fat-free or low-fat (1%) milk, monitor portion sizes, drink water instead of sugary drinks, and make one-half the plate for fruits and vegetables.

The nurse is teaching four clients in a community health center. Which client does the nurse identify as needing more servings per day of milk?

teenager who is in the second trimester of pregnancy Children, adolescents, pregnant women, and breast-feeding mothers require more servings per day of certain food groups, particularly the milk group. Therefore, the teen (adolescent) who is pregnant will require more milk servings. The other clients do not require more servings of milk.

A nurse is caring for a client with a history of cardiac and vascular disease. Which fats should the nurse allow in the client's diet for his condition?

unsaturated fats Unsaturated fat is a healthier form of fat than saturated fat, because it contains less hydrogen, and therefore can be included in the client's diet. Saturated fats are lipids that contain as much hydrogen as their molecular structure can hold and are generally solid. Most saturated fats are found in animal sources, such as the marbled fat in meat. Saturated fats are responsible for cardiac and vascular diseases. Trans fats are unsaturated fats that have been hydrogenated, a process in which hydrogen is added to the fat. Consumption of trans fats, saturated fats, and hydrogenated fats increases the risk of coronary heart disease.

A 16-year-old adolescent informs her nurse that she became a vegetarian 1 year ago. Lately she is reporting fatigue and has trouble concentrating. A quick blood test ordered by her licensed provider informs the nurse that she has pernicious anemia. This is a deficiency of what vitamin?

vitamin B12 Vitamin B12 deficiency is most commonly found in vegetarians, particularly in strict vegans. Individuals who have such rigid dietary restrictions must take care to supplement this vitamin.

A nurse in a rural health center meets a new client, age 4. The nurse notices as the client enters the clinic that his legs appear to be bowed. When he smiles, the nurse also notes that his dentition is quite malformed for a child his age. What vitamin deficiency would the nurse most suspect?

vitamin D Severe vitamin D deficiency manifests as rickets, osteomalacia, poor dentition, and tetany.

The nurse is preparing to administer a client's tube feeding. How should the nurse position the client prior to beginning the infusion?

with the head of the bed at least 30 to 45 degrees Tube feedings should be administered with the head of the client's bed at least 30 to 45 degrees, or as near to normal eating position as possible. Side-lying, low-lying, and supine positions would constitute a risk of aspiration.