Author Question: After inserting a nasogastric tube, what would be the nurse's priority action prior to starting the ... (Read 122 times)

shofmannx20 · **on:** Jul 23, 2018

After inserting a nasogastric tube, what would be the nurse's priority action prior to starting the first tube feeding?

a. Auscultate bowel sounds over the abdomen.
b. Aspirate gastric contents and obtain a pH reading.
c. Obtain radiographic verification (x-ray).
d. Mix the feeding with water for the first feeding only.

Question 2

Which factors in a health history place a patient at risk for hearing loss? Select all that apply.

a. Being an older adult
b. Childhood chickenpox
c. Frequent otitis media
d. Diabetes mellitus
e. Congenital rubella

medine · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

C
Radiographic (x-ray) verification is the only reliable method for confirming tube placement; it must be performed before the first feeding is administered. All feeding tubes contain markings that can be detected by radiographic films. Reliable bedside assessment is necessary following the initial x-ray verification and is used prior to feedings because even when the tube is initially placed correctly in the stomach/intestines and verified by x-ray, it may move upward. However, no bedside method alone is reliable. Feeding tube placement can be checked by testing the pH of the aspirate in combination with other methods; however, this is not the most reliable indication of proper placement prior to a first feeding. Auscultating bowel sounds does not provide any reliable information related to tube placement, although it is an indicator of intestinal motility. For an initial feeding, the prescriber may order the feeding to be mixed with water to assess the patient's tolerance of the feeding. Nevertheless, tube placement must be verified prior to feeding.

Answer to Question 2

A, C, E
Having had frequent ear infections (otitis media) places a patient at risk for hearing loss because of scarring that may have occurred. Older adults experience a generalized decrease in the number of nerve conduction fibers and structural changes in the ear, which cause hearing loss. Sensorineural deafness, eye abnormalities, and congenital heart disease are the classic triad that occurs with congenital rubella. Chickenpox and diabetes mellitus do not place the patient at risk for hearing loss.