A nurse is checking for proper placement of a feeding tube.
Which of the following methods is the most reliable for verification of tube placement?

Choice A rationale

This statement indicates that the client understands advance directives allow them to make decisions about their care while they are still capable. This reflects the purpose of advance directives, which is to respect and uphold the client’s autonomy and choices regarding their medical care.

Choice B rationale

This statement is incorrect because clients can change their advance directives or living will at any time. The purpose of these documents is to provide flexibility and ensure that the client's current wishes are followed.

Choice C rationale

This statement is incorrect. Once a living will is signed and witnessed or notarized, it becomes legally binding without a waiting period. The delay mentioned here is not a part of the advance directive process.

Choice D rationale

This statement is not accurate. A living will usually includes decisions about life support, and a separate consent form is not typically needed for those decisions. The client’s wishes regarding life support would be documented in the living will itself.

Choice A rationale

Hyperactive bowel sounds indicate increased gastrointestinal activity, often associated with conditions like gastroenteritis or diarrhea. While it requires monitoring, it is not immediately concerning in the context of administering medications via a gastrostomy tube.

Choice B rationale

Yellowish-green stomach contents suggest the presence of bile, a normal finding in gastric aspirates. It indicates that the tube is correctly placed in the stomach, which is crucial before administering medications.

Choice C rationale

A pH of 6.5 for aspirated stomach contents suggests that the tube might be dislocated into the respiratory tract or intestines, as normal gastric pH ranges from 1.5 to 3.5. Reporting this finding is critical to avoid complications.

Choice D rationale

A residual volume of 90 mL is within the acceptable range for most clients with gastrostomy tubes. High residual volumes (usually over 200 mL) are more concerning and may require intervention.