Answer to Question 1
A
A. Discuss flushing of tube after administration of feedings or medications to prevent clogging.
B. Discuss measures to stabilize feeding tube in clients with abdominal tubes and to protect skin integrity. This prevents tube from dislodging and prevents skin breakdown.
C. Perform hand hygiene to reduce transfer of microorganisms.
D. Limiting amount of formula hung at one time to amount that can be infused in a 4- to 6-hour period.
Answer to Question 2
C
The point at which the lowest amount of drug is in the serum is the trough concentration. Some medication doses (e.g., vancomycin, gentamicin) are based on peak and trough serum levels. A patient's trough level is drawn as a blood sample 30 minutes before the drug is administered, and the peak level is drawn whenever the drug is expected to reach its peak concentration. The third dose will be given at 1600, which means that the lowest level of drug will be present 30 minutes before the fourth dose at midnight. A patient's trough level is drawn as a blood sample 30 minutes before the drug is administered. 1630 is 30 minutes after the drug is administered. 1800 is 2 hours after the drug is administered. If the medication reaches its peak concentration in 2 hours, this could be a peak concentration, because the peak level is drawn whenever the drug is expected to reach its peak concentration. 2400 is the time that the next dose is due. A patient's trough level is drawn as a blood sample 30 minutes before the drug is administered.
A parish nurse checks the blood pressure of a church member
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Client and therapist positioning for foot reflexology.
Testing the client’s ability to feel vibrations, the knee
Approaching the client for the ophthalmoscopic exam