Chapter 44: Digestive and Gastrointestinal Treatment Modalities 1

feedings stopped too abruptly.

Rebound hypoglycemia is a complication of parenteral nutrition caused by

No land line; cell phone available and taken by family member during working hours

A client is receiving parenteral nutrition (PN) through a peripherally inserted central catheter (PICC) and will be discharged home with PN. The home health nurse evaluates the home setting and would make a recommendation when noticing which circumstance?

Tachycardia Diarrhea Diaphoresis

A nurse is assessing a client receiving tube feedings and suspects dumping syndrome. What would lead the nurse to suspect this? Select all that apply.

Attaches the fat emulsion tubing to a Y connector close to the infusion site

A client is receiving a parenteral nutrition admixture that contains carbohydrates, electrolytes, vitamins, trace minerals, and sterile water and is now scheduled to receive an intravenous fat emulsion (Intralipid). What is the best action by the nurse?

Notify the surgeon about the tube's removal.

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

Auscultate lung sounds every 4 hours.

A nonresponsive client has a nasogastric tube to low intermittent suction due to gastrointestinal bleeding. It is most important for the nurse to

Daily weights Calorie counts for oral nutrients Intake and output monitoring

A nurse is caring for a client receiving parenteral nutrition at home. The client was discharged from the acute care facility 4 days ago. What would the nurse include in the client's plan of care? Select all that apply.

"It is a vent that prevents backflow of the secretions."

A nurse is caring for a patient with a Salem sump gastric tube attached to low intermittent suction for decompression. The patient asks, "What's this blue part of the tube for?" Which response by the nurse would be most appropriate?

X-ray visualization

After teaching nursing students about methods to assess gastric tube placement, the instructor determines that the teaching was successful when the group identifies which of the following as the most accurate method?

1 hour

Semi-Fowler position is maintained for at least which timeframe following completion of an intermittent tube feeding?

260

The client has the intake and output shown in the accompanying chart for an 8-hour shift. What is the positive fluid balance?

the increased potential for aspiration.

The most significant complication related to continuous tube feedings is

Family support Telephone access Motivation for learning Health status

When assessing whether a client is a candidate for home parenteral nutrition, what would be important to address? Select all that apply.

30-mL

A patient is receiving continuous tube feedings via a small bore feeding tube. The nurse irrigates the tube after administering medication to maintain patency. Which size syringe would the nurse use?

Excess fluid volume

A patient is receiving nasogastric tube feedings. The intake and output record for the past 24 hours reveals an intake of 3100 mL and an output of 2400 mL. The nurse identifies which nursing diagnosis as most likely?

120

A patient has a gastric sump tube inserted and attached to low intermittent suction. The physician has ordered the tube to be irrigated with 30 mL of normal saline every 6 hours. When reviewing the patient's intake and output record for the past 24 hours, the nurse would expect to note that the patient received how much fluid with the irrigation?

loose, watery stools.

The nurse conducts discharge education for a client who is to go home with parenteral nutrition (PN). The nurse determines the client understands the education when the client indicates a sign and/or symptom of metabolic complications is

Gastroesophageal sphincter is intact, lessening the possibility of regurgitation.

The nurse is caring for a comatose patient and administering gastrostomy feedings. What does the nurse understand is the reason that gastrostomy feedings are preferred to nasogastric (NG) feedings in the comatose patient?

Keep the vent lumen above the patient's waist to prevent gastric content reflux.

The nurse is managing a gastric (Salem) sump tube for a patient who has an intestinal obstruction and will be going to surgery. What interventions should the nurse perform to make sure the tube is functioning properly?

Flush with 10 mL of water.

The nurse is to discontinue a nasogastric tube that had been used for decompression. What is the first action the nurse should take?