A nurse is preparing to administer a nasogastric (NG) tube feeding to a school-age child. Which of the following actions should the nurse plan to take?
Measure the tubing from the nose to the distal port.
Position the chud at a 10 to 20 angle after feeding.
Complete the feeding in 5 min.
Warm the formula in the microwave
The Correct Answer is A
A. Measure the tubing from the nose to the distal port. Proper placement of an NG tube requires measuring from the tip of the nose to the earlobe, then to the xiphoid process. This ensures the tube reaches the stomach without curling or entering the airway.
B. Position the child at a 10 to 20 angle after feeding. A head elevation of at least 30 to 45 degrees is necessary during and after NG feedings to reduce the risk of aspiration. A 10 to 20 degree angle is too low and unsafe for post-feeding positioning.
C. Complete the feeding in 5 min. NG feedings should be given slowly over 20 to 30 minutes to prevent gastrointestinal discomfort, cramping, or vomiting. A 5-minute infusion is too rapid and may overwhelm the child’s digestive capacity.
D. Warm the formula in the microwave. Microwaving formula can lead to uneven heating and hot spots, which pose a burn risk to the child. Formula should be warmed by placing the container in warm water and testing the temperature before administration.
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Related Questions
Correct Answer is B
Explanation
A. "You have already consented to this treatment, so you must continue." This response disregards the client’s autonomy. Clients have the right to withdraw consent and stop treatment at any time, even after initially agreeing to it.
B. "I will let your doctor know that you want to discontinue treatment." This response respects the client’s right to make decisions about their care and ensures that the healthcare team is informed to support the client appropriately. It demonstrates advocacy and ethical practice.
C. "You should discuss this with your family and see if they agree." While family input can be helpful, the final decision rests with the client, not their family. This response may undermine the client’s autonomy.
D. "I know this treatment is difficult for you, but you will feel better." This is a minimizing statement that may come across as dismissive. It does not acknowledge the client’s feelings or support their decision-making process.
Correct Answer is C
Explanation
A. Administer packed RBCs. While blood transfusion may be urgently needed for hemorrhagic shock, it cannot be initiated until vascular access is established. It is important, but not the first step.
B. Obtain a specimen for ABG analysis. Arterial blood gases can provide valuable information about respiratory and metabolic status, but they are not the top priority in an unstable trauma patient.
C. Place a large-bore IV catheter in an upper extremity. Establishing IV access is the priority in trauma care, as it allows for rapid fluid resuscitation and medication administration. This intervention supports all subsequent emergency treatments.
D. Insert an indwelling urinary catheter. A catheter may be necessary for monitoring urine output as a sign of perfusion, but this is not the first action in a trauma situation where immediate stabilization is the priority.
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