Question

Ida Parker, a 67 year-old patient, was admitted to the intensive care unit with the diagnosis of lung cancer and underwent a left lower lobectomy. The patient has a history of Parkinson’s disease. The patient was two days postoperative when the nurse noted that the patient had not received her anti-Parkinson’s medications for two days. The patient was frozen and unable to move or talk to the nurse. 1. What actions should the nurse take next? 2. The physician reorders the carbidopa-levadopa (Sinemet) and benztropine meysylate (Cogentin). The physician orders an enteral feeding tube placed and confirmed by chest X-ray. Once the radiologist has confirmed correct placement, tube feeding with the specified formula that is higher in carbohydrates and lower in protein will begin. What is the rationale for the enteral feeding tube? How should the nurse administer the medications?

Answer 1

1. The nurse should take immediate action of

• Ensure safety measures by placing side rails and keep away from all objects to prevent injury and falls.
• Monitor vital signs.
• Assess the patient level of function.
• Assess the surgical site for the proper healing of wounds.
• Assist in the daily activities of the patient.
• Provide charts and pictures for communication.
• Encourage and support to cope up with the abilities.
• administer of the medications.

2. The enteral feeding tube is inserted for this patient as he was unable to swallow the food as a result of muscle rigidity due to Parkinson's disease. So to meet the nutritional requirements of the patient and to administer medication, the physician has been ordered for enteral tube feeding. The nurse should administer enteral tube feeding by following techniques of

• Ensure the feeding tube is in the right position before the administration of medication.
• Adequately flush the enteral tube before and after the medication administration.
• Maintain hygienic measures.
• Crush the medication into a fine powder and then mix with water.
• Then administer slowly into the enteral tube by using the syringe.
• Each medication should be administered separately.
• Enteric coated should not be given.