321 Exam 3 - Ch 44: Digestive/GI Treatment Modalities

The nurse is inserting a nasogastric tube for a patient with pancreatitis. What intervention can the nurse provide to allow facilitation of the tube insertion?

allow pt to sip water as the tube is being inserted

A client recovering from gastric bypass surgery accidentally removes the nasogastric tube. What is the best action by the nurse?

notify surgeon about removal

The nurse teaches an unlicensed caregiver about bathing clients who are receiving tube feedings. The most significant complication related to continuous tube feedings is the

potential risk for aspiration

The nurse observes dry mucous membranes in a client who is receiving tube feedings after an oral surgery. The client also reports unpleasant tastes and odors. Which measure should be included in the client's plan of care?

provide frequent mouth care

A nurse is caring for a client with a long-term central venous catheter. Which care principle is correct?

clean the port with an alcohol pad before administering iV fluid thru the catheter

A nurse administered a full strength feeding with an increased osmolality through a jejunostomy tube to a client. Immediately following the feeding, the client expelled a large amount of liquid brown stool and exhibited a blood pressure of 86/58 and pulse rate of 112 beats/min. The nurse

consult with the physician about decreasing the feeding to half-strength

To ensure patency of central venous line ports, diluted heparin flushes are used

daily when not in use

The nurse is inserting a Levin tube for a patient for gastric decompression. The tube should be inserted to 6 to 10 cm beyond what length?

distance from tip of nose to earlobe and from earlobe to xiphoid process

The nurse assesses a patient who recently had a nasoenteric intubation. Symptoms of oliguria, lethargy, and tachycardia in the patient would indicate to the nurse what common complication?

fluid volume deficit

Gastrostomy feedings are preferred to nasogastric feedings in the comatose patient, because the:

gastroesophageal sphincter is intact, lessening the possibility of regurgitation and aspiration

A client has a gastrointestinal tube that enters the stomach through a surgically created opening in the abdominal wall. The nurse documents this as which of the following?

gastrostomy tube

Residual content is checked before each intermittent tube feeding. The patient would be reassessed if the residual, on two occasions, was:

greater than 200 mL

When a central venous catheter dressing becomes moist or loose, what should a nurse do first?

remove the dressing, clean site, and apply a new dressing

The client is on a continuous tube feeding. The nurse determines the tube placement should be checked every

shift

The nurse is inserting a nasogastric tube and the patient begins coughing and is unable to speak. What does the nurse suspect has occurred?

the nurse has inadvertently inserted the tube into the trachea

The nurse monitors a client with nasoenteric intubation. When should the nurse contact the physician?

urinary output 20 mL/hour

The nurse checks residual content before each intermittent tube feeding. When should the patient be reassessed?

when residual is greater than 200 mL