The charge nurse observes a new nurse during the administration of two different liquid medications at once through a gastrostomy tube used for enteral feeding. The charge nurse observes the new nurse's actions, as seen in the video. What action(s) should the charge nurse take? (Select all that apply.)
Encourage the novice to flush the tube with more water.
Instruct the novice to administer each medication separately.
Add the liquid volumes when documenting fluid intake.
Confirm that the novice determined the amount of gastric residual.
Advise the novice to use the plunger when giving medications.
Correct Answer : A,B,C,D
The correct answer is A, B, C, and D.
Choice A reason: Flushing the gastrostomy tube with water is essential to maintain tube patency and prevent medication interactions. It should be done before and after medication administration. The typical amount of water used for flushing can range from 15 to 30 mL.
Choice B reason: Administering each medication separately is a critical practice to prevent drug interactions and ensure that the full dose of each medication is delivered. It also helps in preventing the clogging of the tube.
Choice C reason: Documenting all liquid volumes, including medications and water used for flushing, is important for accurate fluid intake records. This helps in maintaining fluid balance and monitoring the patient’s hydration status.
Choice D reason: Checking gastric residual volume is important to assess the patient’s tolerance to enteral feeding and to prevent complications such as aspiration. Normal gastric residual volumes are generally considered to be less than 250 mL.
Choice E reason: Using a plunger to administer medications through a gastrostomy tube is not always recommended. Medications should be administered slowly to prevent discomfort or harm, and the use of a plunger is not a standard practice across all healthcare settings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["31.6"]
Explanation
The correct answer is : 31.6 mL
Let’s calculate this step by step:
Step 1: Convert 10 mg of teriparatide to mcg. We know that 1 mg = 1000 mcg. So, 10 mg = 10 × 1000 mcg = 10000 mcg.
Step 2: The medication is labeled as 760 mcg/2.4 ml. This means that 760 mcg of the medication is present in 2.4 mL.
Step 3: Now, we need to find out how many ml will contain 10000 mcg of the medication. We can set up a proportion to solve this:
(760 mcg / 2.4 ml) = (10000 mcg / x mL)
Step 4: Solving for x, we cross-multiply and divide:
x ml = (10000 mcg × 2.4 ml) ÷ 760 mcg
Step 5: Calculate the result:
x ml = 24000 mcg·ml ÷ 760 mcg = 31.57894736842105 mL
Step 6: If rounding is required, round to the nearest tenth:
x ml = 31.6 mL
So, the nurse should administer 31.6 mLof the medication.
Correct Answer is B
Explanation
Choice A: Recommending the use of support stockings to enhance venous return is not a priority intervention for the nurse, as this does not address the underlying cause of the peripheral edema, which is fluid overload due to inadequate dialysis. This is a distractor choice.
Choice B: Ensuring the client receives frequent small meals containing complete proteins is a priority intervention for the nurse, as this can help improve the client's nutritional status and increase their serum albumin level, which can reduce fluid leakage into the interstitial spaces and decrease edema. Therefore, this is the correct choice.
Choice C: Evaluating patency of the AV graft for resumption of hemodialysis is not a priority intervention for the nurse, as this is not feasible at this point since the AV graft is no longer available to use. This is another distractor choice.
Choice D: Instructing the client to continue to follow the prescribed rigid fluid restriction amounts is not a priority intervention for the nurse, as this does not address the root problem of inadequate dialysis and low serum albumin level, which are contributing to fluid overload and edema. This is another distractor choice.
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