When assessing a client receiving bolus enteral feedings, which lab value suggests a change in formula is needed?

A blood urea nitrogen (BUN) level of 28 mg/dL indicates potential dehydration or a concern with protein metabolism. In clients receiving enteral feedings, a significantly elevated BUN could suggest that the formula may not be meeting the client's nutritional needs adequately, particularly in terms of hydration or protein content. Elevated BUN levels in this context may indicate that the kidneys are concentrating waste products due to dehydration or insufficient fluid intake, suggesting that a change in the enteral formula or an increase in hydration is necessary to support optimal renal function and overall metabolic status.

In contrast, while the other lab values provide useful information about the client’s health, they do not necessarily indicate an urgent need to change the enteral feeding formula. The hematocrit level of 42% is within a normal range and does not imply issues with the feeding formula. A urine specific gravity of 1.022 reflects normal hydration status, suggesting that the client is not dehydrated. Sodium at 142 mEq/L is also within a normal range, indicating that there are no electrolyte imbalances needing immediate attention related to enteral feeds.