Question

Case Study, Chapter 70, Management of Patients With Oncologic or Degenerative Neurologic Disorders 1. 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 2 days postoperative when the nurse noted that she had not received her anti-Parkinson's medications for 2 days. The patient was frozen and unable to move or talk to the nurse. (Learning Objective 4) a. What actions should the nurse take next? b. The physician reorders the carbidopa-levodopa (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

a. ANS: Actions should the nurse take:

(i) Support coping abilities

(ii) Encourage alternate mode of communication techniques.

(iii) Safety Precautions

(iv) Monitor vital signs especially for BP

(v) Get an order for anti-Parkinson drug.

b. ANS: The patient has a decreased level of consciousness and cannot feed appropriately. This necessitates placement of the enteral feeding. This route can also be used to administer the drugs when compounded to a liquid form.

Explanation:

The patient is at risk of aspiration and imbalanced nutrition because of the inability to talk which reflects an inability to feed orally. Such patients are usually prescribed alternative feeding methods. The tablets can be compounded and made into a liquid form before administration through the enteral route. The drugs cannot be skipped because the symptoms of parkinson's disease will compound.

Answer 2

The nurse should call the physician