Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What intervention may be ordered if C. diff and impaction are ruled out in tube-fed patients experiencing diarrhea?

1. Increase fiber in the diet

2. Use antiperistaltic agents

3. Discontinue tube feeding

4. Add more fluids

The correct answer is: Use antiperistaltic agents

Utilizing antiperistaltic agents is appropriate in the context of tube-fed patients experiencing diarrhea when Clostridium difficile infection and bowel impaction have been ruled out. These agents work by slowing down gut motility, which can help reduce the frequency and volume of diarrhea. In patients receiving tube feeds, diarrhea can lead to complications such as dehydration and electrolyte imbalances, so an intervention to manage and reduce these symptoms is essential. Increasing dietary fiber is typically recommended to bulk up stool in cases of certain types of diarrhea, but in the setting of tube feeding, especially when strict guidelines about the feed consistency and composition must be adhered to, this might not be feasible or effective without tailoring the feed itself. Discontinuing tube feeding may not be warranted as a first response, especially if the underlying cause has been eliminated. It could lead to nutritional deficiencies if not closely monitored and managed properly. Adding more fluids, while beneficial for dehydration, does not directly address the diarrhea issue and could potentially exacerbate the situation if the underlying cause has not been resolved. Therefore, administering antiperistaltic agents represents a direct and appropriate intervention to help manage the symptomatology in this clinical scenario.