A patient is mechanically ventilated and is receiving enteral nutrition via a nasogastric tube. To help ensure feeding tolerance, the nurse checks residual volumes every 4 hours. During a residual check later in the shift, the nurse aspirates a total residual volume of 200 mL. What action should the nurse take next?

Discontinue tube feeding and call the practitioner for parenteral nutrition orders

Stop the tube feeding, wait 1 hour, and recheck the residual

Continue the tube feeding and place the patient in the left lateral decubitus position to facilitate gastric emptying

Continue the tube feeding if no other gastrointestinal symptoms exist and reassess the patient with the next residual check

Answer and Explanation

The Correct Answer is B

A. Discontinuing the tube feeding and transitioning to parenteral nutrition is not the first action, as the residual volume may be manageable with additional interventions.
B. A residual volume of 200 mL is above the usual threshold, so the nurse should stop the feeding, wait, and recheck the residual to assess if it improves.
C. While positioning can help gastric emptying, the immediate action should be to stop the feeding and reassess before continuing.
D. Continuing the feeding without rechecking the residual volume would be premature, as the volume is higher than expected, potentially increasing the risk of aspiration.

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Free Nursing Study Resources

Correct Answer is ["21.6"]

Explanation

 Convert pounds to kilograms:

198 lbs / 2.2 lbs/kg = 90 kg

 Calculate the medication dose in mcg/min:

90 kg 4 mcg/kg/min = 360 mcg/min

 Convert mcg/min to mg/hr:

360 mcg/min 60 min/hr = 21600 mcg/hr
21600 mcg/hr / 1000 mcg/mg = 21.6 mg/hr

 Determine the medication concentration:

250 mg / 250 mL = 1 mg/mL

 Calculate the infusion rate in mL/hr:

21.6 mg/hr / 1 mg/mL = 21.6 mL/hr

A. Placing the patient in prone position to improve draining from mouth B. Checking to make sure the tracheostomy cuff is inflated during tube feedings C. Placing the patient in the right lateral decubitus position to promote gastric emptying D. Discussing the use of metoclopramide to facilitate gastric motility with the practitioner

Correct Answer is B

Explanation

A. The prone position is not recommended for managing tube feeding regurgitation, as it could lead to aspiration into the lungs.
B. The first priority is to ensure that the tracheostomy cuff is inflated during tube feedings to prevent aspiration and to ensure that the feeding is directed into the stomach and not into the airway.
C. The lateral decubitus position can help with gastric emptying, but the priority is to ensure proper cuff inflation to prevent aspiration.
D. While metoclopramide may help with gastric motility, the immediate concern is managing the risk of aspiration, which requires confirming cuff inflation.

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Naxlex Comprehensive Predictor Exams

The Provider orders an IV weight-based medication to be infused at 4 mcg/kg/min. The patient weighs 198 lbs. You are supplied with a bag of the IV medication that reads 250mg/250 ml. How many mL/hr will you administer? NOTE DO NOT write the unit/s of measurement DO NOT round your answer

Correct Answer is ["21.6"]

Explanation

A tracheostomy patient is experiencing regurgitation of tube feeding formula. What should be the nurse's first priority?

Correct Answer is B

Explanation

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