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.
Nurse-patient interaction; nonverbal communication
The nurse applies a pulse oximeter sensor on the client’s finger.
A physician is performing a colonoscopy on a client and viewing the internal structures of the colon
Use face cradle covers to prevent the client’s skin from touching the face cradle upholstery.
Removing the sheet from underneath the client.
Client files are kept in alphabetical order in locked file cabinets.