A preschool-age child has not been able to eat for several days ...

[K@]

A preschool-age child has not been able to eat for several days until all diagnostic tests are complete to determine the cause of chronic diarrhea. Which nursing diagnosis should the nurse identify as being appropriate for the patient at this time?
 
  A) Risk for injury related to intrusive procedures
  B) Fear related to new and strange surroundings of procedure rooms
  C) Deficient diversionary activity related to hospitalization and frequent procedures
  D) Imbalanced nutrition, less than body requirements, related to food restriction for procedures

Question 2

A nasogastric tube for enteral feedings has just been inserted in a 6-month-old infant. What should the nurse do to assess if the tube is in the patient's stomach?
 
  A) Aspirate the tube for stomach contents.
  B) Administer 1 ml of fluid and observe for coughing.
  C) Listen at the distal end of the tube for bowel sounds.
  D) Lower the end of the tube and observe for drainage.

[mathjasmine]

Answer to Question 1

D
Feedback:
Because the child has not been able to eat for several days, the risk for imbalanced nutrition is high. This is the appropriate diagnosis for the nurse to select at this time. There is no enough information to determine if the child is at risk for injury, fearful of procedure rooms, or experiencing a deficiency in diversionary activities.

Answer to Question 2

A
Feedback:
It is necessary to use a syringe to aspirate the tube for any stomach residual before a feeding because it confirms the tube's placement in the stomach. Fluid should not be introduced through the nasogastric tube until placement has been confirmed. Listening for bowel sound and lowering the tube for drainage are not appropriate techniques to assess for nasogastric tube placement in an infant.

[K@]

Excellent

[yeungji]

TYSM