Question

1. A patient’s CPN solution has gotten behind in the rate of administration. As the nurse, you realize that the patient needs the nutrients. What interventions could be initiated and what actions would be contraindicated? (Give a rationale for your interventions.)

2. In the long-term care home, the patient on a continuous tube feeding could have the tube feeding scheduled to run at night, thus leaving greater mobility during the daytime. If the patient has to have an intake of 80 mL/hr over a 24-hour span, how would the hourly intake be adjusted to administer the enteral product between 8 pm and 8 am?

3. Explain teaching for an adult being discharged on bolus enteral feedings. How would you teach the patient to administer the enteral product and what monitoring for complications should be done before discharge home?

4. It is time to hang the next bag of CPN but it has not arrived from the pharmacy. What would be appropriate actions for the nurse to take?

Answer 1

1 . WHAT INTERVENTION COULD BE INITIATED;

action to be contraindicated;

O check weight, Temperature, Intale and output of fluid . change IV tube and filter every 24 hours ik done for reducing the risk of Infections. 3 keep The solution refrigerator, weak dose from The refrigerator four to to s six hours before using it because to waim The room temperature 6 Add any medication as multivitamin before using CAN bag 6. monitor the client for Hyperosmolarity, oflend overload, headach, nausea, fever, makaise, o check for hypoglycemia of The the Tachycardia, cool clammy skis, on the patient

should not give above 125 ml / hr PARENTERAL nutrition to the patient,

Air bubble in the the syringe lead to air embolism to the patient,severely contraindicated.

If the the patient had pneumothorax,hematoma should not done the parenteral nutrition.

2.Can be given in 125ml/ hr in divided dose can be given for 12 hrs.

3.TEACHING TO THE PATIENT ABOUT ENTERAL PRODUCTS ADMINISTRATION:

• Tell to the patient by cleaning the workspace by disinfectant wipes.
• Wash your hands with soap and water and gather the following items,tubing and pump,normal saline syringe,two alcohol pads and sterile gauze pads, multi vitamins,tell them again to clean your hands.
• Do the procedure by prepare the CPN bag with multi vitamins,tell them to wipe the top of vial with alcohol pads,next attach the needle to empty syringe by twisting and cap of the syringe to be removed,add a little bit of air into your syringe and you can push the air into the vial,finally draw out the liquid in the vial,check there is no air bubble in the syringe.
• Wipe the part of the CPN bag,where u going to inject the multi vitamin and inject all the multivitamin into CPN bag,throw away the usage syringe and tell to hold the bag ,gently mix the multivitamin in the bag.
• Take IV tube and hook the tubing up to the pump,before that spike the bag with tube.attach the IV tube to the CPN bag.
• Place the bag vertically hang it down from the top,IV tube downwards.
• CAD cassette of tube hook to tha pump by their hinge,pump is used for the constant rate to prevent abrupt change in the infusion rate.start the pump,fluid from the bag enters into central vein i.e subclavian vein.

MONITOR THE COMPLICATION BEFORE DISCHARGE;

• Check compeletly blood count,chest X ray for pneumothorax,serum albumin,sepsis,weight of the patient,prothrombin time,platelet count and liver function test.
• Check the glucose level of the patient and electrolytes,blood urea nitrogen.

4.APPROPRIATE ACTION OF THE NURSE,WHEN COMPLETE PARENTERAL NUTRITION BAG NOT AVAILABLE;

• 10% dextrose and water ​​​​​​ or Saline temporarily to avoid rebound hypoglycemia.