Question

65 year old Asian female complain of nausea and vomiting 2 weeks. Height 5-5. Weight 108 pounds. Nasal gasrtro (NGT) ordered with feeding at 70 cc/ hr. Total parenteral nutrition at 50 cc/ hr. Foley cath to gravity. IV: Normal saline 75 cc/hr. 1. Calculate the patient's BMI and explain the result 2. Explain the purpose of NGT. Review video on nurse inserting NGt . 3. How does the nurse measure the tube for placement? 4. A)Explain the purpose of TPN. B.)What are the complications of TPN? C.) Identify nursing interventions for TPN. 5. Why would the doctor order a fleet enema day 3 ? Please complete questions. We will discuss answers.

Answer 1

1. BMI

Patient height is 5.5

Patient body weight is 108

100 cm is 1 meeter

1 feet = 30 cm

12 inches - 1 feet

5.5 × 30 =165 cm

165 - 100 = 65

Actually patient want normal weight is 65 kg but here patient weight is 108 .so patient here overweight 43 kg.so patient is having obesity.so want to decrease 43 kg.

2. A nasogastric tube ( NG tube) is a special tube that carries food and medicine to the stomach through the nose.it can be used for all feedings or for giving a person extra calories.you'll learn to take good care of the tubing and skin around the nostrils so that the skin around the nostrils so that the skin doesn't get irritated.

3. * Position the patient sitting up right with their head in a neutral position.

* Don a pair of non sterile gloves

* Estimate how far the NG tube will need to be inserted: measure from the bridge of the nose to the ear lobe and then down to 5cm below the xiphisternum .

* lubricate the tip of the NG tube

* if available a local anesthetic should be sprayed towards the back of the patient's throat.

* warn the patient you are about to insert the NG tube.

* insert the NG tube through one of the patient's nostrils.

* gently advance the ng tube through the nasopharynx

* this is often the most uncomfortable part for the patient

* if resistance is met rotating. the ng tube can aid insertion.avoid forcing the NG tube if significant resistance is encountered.

* if the patient becomes distressed ,pause to give them some time to recover.

* intermittently inspect the patient's mouth to ensure the NG tube isn't coiling within the oral cavity.

* continue to advance the NG tube Down the oesophagus: ask the patient to take some sips of water and then swallow as this can facilitate the advancement of the NG tube.avoid giving patient's a drink if their swallow us deemed unsafe, due to the risk of aspiration

* once you reach the desired nasogastric tube insertion length, fix the NG tube to the nose with a dressing.

* aspirate the gastric content.if aspiration is successful mean its correct placement.

4. Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract.fluids are given into a vein to provide most of the nutrients the body needs.the method is used when a person cannot or should not receive feedings or fluids by mouth.

Complications TPN

* Dehydration and electrolyte imbalance

* thrombosis

* hyperglycemia

* hypoglycemia

* infection

* liver failure

* micronutrient deficiencies ( vitamin and minerals)

Interventions:

Struct adhere to aseptic technique with insertion,care,and maintenance; avoid hyperglycemia to prevent infection.closely monitor vital signs and temperature. IV antibiotic therapy is required.monitor white blood cell count and patient for malaise.

* measure intake and output accurately; monitor weight daily; monitor calories counts, including calories provide by TPN

* encouraged additional oral fliud intake as indicated .

* administer the prescribed rate of TPN solution via an infusion pump.

* handle with caution on extremities with edema.

* administer diuretics such as furosemide as indicated.

5. Our original and best- selling product, the feet enema is a saline laxative that provides reliable relief from occasional constipation without pain or spasm.you may be constipated if you have three or fewer bowel movements in a week,and your stools are hard,dry and difficult to pass.Enemas can treat constipation and clear out your bowel.