A patient is mechanically ventilated and is receiving enteral ...

[leilurhhh]

A patient is mechanically ventilated and is receiving enteral nutrition via a nasogastric tube
 
  To help ensure feeding tolerance, the nurse checks residual volumes every 4 hours. During a residual check later in the shift, the nurse aspirates a total residual volume of 350 mL. The nurse will
 
  a. stop the tube feeding, wait 1 hour, and recheck the residual.
  b. discontinue the feeding tube and tube feeding and call the physician for TPN orders.
  c. continue the tube feeding, if no other gastrointestinal symptoms exist, and reassess the patient with the next residual check.
  d. continue the tube feeding and place the patient in the left lateral decubitus position to facilitate gastric emptying.

Question 2

An 82-year-old patient is admitted into the critical care unit with a diagnosis of left-sided heart failure related to mitral stenosis
 
  Physical assessment findings reveal tachycardia with an S3 and a 3/6 systolic murmur. The grading of a murmur as a 3/6 refers to which of the following characteristics of murmurs?
 
  a. Intensity
  b. Quality
  c. Timing
  d. Pitch

[ecabral0]

Answer to Question 1

C
There is little evidence to support a correlation between gastric residual volumes and tolerance to feedings, gastric emptying, and potential aspiration. Except in selected high-risk patients, there is little evidence to support holding tube feedings in patients with gastric residual volumes less than 400 mL.

Answer to Question 2

A
Intensity, or the loudness, is graded on a scale of 1 to 6; the higher the number, the louder the murmur.

[leilurhhh]

Gracias!

[pratush dev]

Excellent