A nurse is providing site care for a child who has a gastrostomy enteral tube. Which of the following actions should the nurse take?
Tape the tube to the child's cheek.
Apply water-soluble lubricant to the site.
Attach an extension tube to the site's opening prior to use.
Secure the tubing to the child's abdomen.
The Correct Answer is D
A. Taping the tube to the child's cheek is not a recommended practice. It can cause skin irritation, discomfort, or even accidental removal of the tube. Proper securing of the tube to the abdomen using appropriate devices is the preferred method to prevent dislodgement.
B. Applying water-soluble lubricant to the gastrostomy site routinely is not recommended because it can trap moisture, leading to maceration or infection.
C. Some gastrostomy tubes require an extension set for feeding, especially low-profile devices (e.g., button-type gastrostomy tubes). This extension makes it easier to administer feeds or medications and can be removed afterward. However, this is not typically part of routine site care.
D. Securing the tubing to the child's abdomen helps prevent accidental dislodgement or pulling of the gastrostomy tube. This can be done using appropriate securing devices, such as adhesive dressings or commercially available tube holders, as recommended by the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is B.
Initiate droplet precautions. The rationale is that RSV is a highly contagious viral infection that causes respiratory tract inflammation and can spread through respiratory droplets from coughing or sneezing. The nurse should wear a mask and gloves when caring for the preschooler and isolate them from other children to prevent transmission.
Correct Answer is B
Explanation
The correct answer is choice b. I will need to remain upright for 1 hour after taking the medication.
Choice A rationale:
Pantoprazole can be taken with or without food, so it does not need to be taken on an empty stomach.
Choice B rationale:
Remaining upright for at least 1 hour after taking pantoprazole helps prevent acid reflux and ensures the medication works effectively.
Choice C rationale:
Diarrhea is a possible side effect of pantoprazole, but it is not an expected outcome for all patients. If diarrhea occurs, it should be reported to a healthcare provider.
Choice D rationale:
Antacids can be taken with pantoprazole, but it is generally recommended to take them at different times to avoid potential interactions.
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