a) You are caring for a patient with an NG feeding tube.

Before administering the

patient’s tube feeding, you explain to the patient that you will be checking to make
sure the tube is placed correctly. The patient responds that she is accustomed to this
and that the other nurses “check the tube by placing the end of it in a cup of water;”
the patient also states that the nurses then “put air in the tube and use a stethoscope
to listen for bubbles in my stomach.” How would you respond to the patient? What
research findings guide your actions in confirming the placement of the tube? What
follow-up actions would you take to ensure that there is consistency among the
nursing staff in the procedure used for confirmation of tube placement?.
 The nurse would respond to the patient that there are instances that that the tube is not positioned
correctly so the nurse has to start the process from the beginning and continue until the NG tube is
placed correctly. By placing the end of the tube in a cup of water (bubbles indicate that the tube is in
place), placing a stethoscope over the patient’s epigastrum while instilling a 30 cc air bolus using an
irrigation syringe (the air enters the stomach when a whooshing sound is heard). If these actions are
not confirmed so I may immediately remove the tube and start the process from the beginning.
 The Placement of Nasogastric Tube, the research findings that guide my action in confirming the
placement of the tube. It tells also the potential life-threatening complications if not positioned
properly.
 I have to make sure that all the nursing staff must follow the certain measures to verify the
placement of the tube. Methods used for checking correct placement of nasogastric tube should be
followed.

References:
 https://www.registerednursern.com/ng-tube-placement-how-to-check-nasogastric-tube-
placement-nursingskills/#:~:text=Nurses%20can%20check%20the%20placement%20of%20the
%20patient%E2%80%99s,Unit%20as%20well%20as%20patients%20with%20swallowing
%20issues
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2871204/

b) A patient who is receiving gastrostomy tube feedings is to be discharged from the hospital to
return home within the next few days. Several family members are to be taught how to
administer the tube feedings. What are the learning priorities that should be accomplished
before the patient is discharged? What assessment parameters should be used to determine
whether the family has the necessary resources for providing care for the patient at home?
 The discharge instructions of caring for the gastrostomy tube would be the priority of
the patient and member of the family to be learned before the patient is discharge. If
the tube comes out all the way. The patient or the family member will call right away a
healthcare provider and don’t wait until the next day. The patient also must learn how
to replace the tube at home. More importantly they must learn the General Guidelines
for use, like washing the hands thoroughly before starting feeding.
 I guess for me, it’s the learning of the family member on how to take care of the patient
as instructed by the healthcare provider. The proper procedure on taking care should be
followed and most importantly the time of the person who takes care of the patient.
References:
https://www.fairview.org/sitecore/content/Fairview/Home/Patient-
Education/Articles/English/d/i/s/c/h/Discharge_Instructions_Caring_for_Your_Gastrostomy_Tube_GTub
e_86493

c) A patient who had major abdominal surgery 1 week ago and who has developed a paralytic ileus
is to begin receiving PN. What explanation would you give to this patient about the benefits of
PN and the procedure for its administration? How would you alter your plan of care to include
assessment for complications of PN? What assessment would you conduct to determine
whether the patient is a candidate for home PN therapy?
 I would explain to the patient that parenteral nutrition delivers nutrients such as sugar,
carbohydrates, proteins, lipids, electrolytes, and trace elements to the body and it
would be given intravenously.
 In altering the plan of care and to include assessment for complication of PN is by
reviewing the Patient Medical history. On postoperative patient, underfeeding and
malnutrition are risk factor for postoperative complications. So making it sure that the
patient will not be at risk for any complications, nutritional assessment should be
included and make sure to focused on the issue of nutritional support therapy.
 The assessment that would be conducted to determine whether the patient is a
candidate for home PN therapy is that the patient’s medical condition is stable. They will
also be monitored closely for growth with their nutritional status and laboratory results.
Before discharge laboratory values would be normal and stable regimen has been
achieved.

References:
 https://www.google.com/search?
q=family+assessment+in+caring+for+gastrostomy+patient&oq=family+assessment+in+caring+fo
r+gastrostomy+patient&aqs=chrome..69i57.29241j0j4&sourceid=chrome&ie=UTF-8
 https://www.thepharmajournal.com/archives/2017/vol6issue12/PartB/6-11-104-333.pdf
