...appropriate and effective means of providing nutrition for individuals who are unable to achieve adequate nourishment orally because of various medical problems. However, the delivery of nutrients by tube feeding can cause ethical dilemmas in cases where the effectiveness of tube feeding diminishes and medical complications increase. The decision to tube feed is often influenced by regional and cultural preferences, as well as the high cost of providing mealtime assistance. The effectiveness and appropriateness of tube feeding has been the subject of much debate as it applies to those with severe cognitive impairments and those who are in a persistent vegetative state (PVS). Recent research shows that in these vulnerable populations, tube feeding alone does not necessarily prevent malnutrition and risk of infection or improve functional status and comfort. While advanced directives allow an individual to make decisions about his or her care at the end of life, court cases and religious doctrine examine the individual’s right to autonomous decision making in opposition to preserving the sanctity of life. As long as the outcome of this debate is largely undecided, the process of dying may be prolonged for those who can no longer advocate for themselves. Keywords: Enteral feeding, tube feeding, ethics, persistent vegetative state, dementia, palliative care Introduction Nutrients are introduced into the body in two ways: by enteral feeding through the digestive tract,...
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...GI and Diabetes Exam Study Guide Tube Feeding – (enteral nutrition) refers to the administration of a nutritional balanced liquefied food or formula through a tube inserted into the stomach, duodenum, jejunum. It is used to provide nutrients via the GI tract either alone or as a supplement to oral or parenteral nutrition. - Nasogastric (NG) Tube – is most commonly used for short-term feeding problems. Other means of feeding are; esophagostomy, gastrostomy or jejunostomy. Transpyloric tube placement or placement into the jejunum is used when physiologic condition warrant feeding the pt below the pyloric sphincter. Special Indications – anorexia, orofacial fractures, head and neck cancer, neurologic or psychiatric conditions that prevent oral intake, extensive burns and those who are receiving chemotherapy or radiation therapy. Procedure for tube feeding 1. Patient position – 30-45 degrees position. Head remain elevated for 30-60 mins 2. Patency of tube – Tube should be irrigated with water before and after each feeing to ensure patency. 3. Tube Position – Placement of tube is checked before each feeing or every 8 hours with continuous feeings. Checking methods; aspiration and pH. 4. Formula 5. Administration of feeding – feeing are given either by gravity drip method or by feeding pump. 6. General Nursing Considerations – daily weight, accurate I’s and O’s. Blood glucose check. Complication Related To tube and feeding - Vomiting and or Aspiration -...
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...Delivery of specialized care to critically-ill patients with life-threatening such as major surgery, trauma, infection, and shock as well as prevention of potential life-threatening conditions. The critical care nurse is responsible for ensuring that all critically-ill patients and families receive optimal care. Common Illnesses and Injuries seen in ICU: 1. GSW (Gunshot Wounds) 2. Traumatic Injuries (car collision & falls) 3. CV D/O (heart failure, acute coronary syndrome, unstable angina, MI) 4. Surgeries (abdominal aortic aneurysm repair and endarterectomy) 5. Renal D/O (acute and chronic renal failure) 6. GI and Hepatic D/O (acute pancreatitis, acute UGIB or Upper Gastro Intestinal Bleeding, acute liver failure) 7. Cancer (lungs, esophageal & gastric) 8. Shock due to hypovolemia PRINCIPLES OF CRITICAL CARE NURSING Maintains the establishment standards of CCN practice Continually updates knowledge necessary for competence as an integral part of the multidisciplinary health care team, coordinates care delivered to patient and supports families within the CC environment. Must...
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...Dear nutrition student, Thank you for inquiring about my RD/DTR study guide. And yes, there is no catch, the study guide is COMPLETELY FREE! All I ask for is some feedback. So feel free to shoot me any questions/comments! A little background: This study guide is the culmination of years of my own research. And after careful thought, I put into the study guide what I feel are the most important concepts you need to know for the RD/DTR exam. If you notice, I spent much time teaching you in detail the concepts you need to know, not just “spitting” you questions with little or no explanation. I believe this is important. I know you might be thinking “oh, how am I going to absorb and learn all this material?” I say, just read and answer the questions at your own pace. Simply test yourself and of course take some breaks along the way. Just take it one concept at a time. After you have mastered one concept, then move on to the next. I know if you study whole-heartedly what I have outlined in this study guide, you are sure to pass! GOOD LUCK! YOU CAN DO IT! ϑ Your nutrition friend, -Jonathan Brown, B.S, DTR THE “NO FLUFF” RD/DTR STUDY GUIDE *Updated as of July 2011 The “NO FLUFF” RD/DTR STUDY GUIDE Tips for taking the RD/DTR exam 1. PERIODICALLY CHECK THE CLOCK TO MAKE SURE YOU’RE GOOD ON TIME! If you wish, get a basic digital watch with a timer for...
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...Practice Examination One Part One You will have two hours and 30 minutes to complete Part One. 1. The nurse is instructing an unlicensed assistant on how to collect a urine specimen from an indwelling catheter. Which of the following statements indicates that the assistant understands the instructions? A. "I will empty the catheter drainage bag, have the client drink some water, and an hour later collect the urine that drains into the bag. " B. "I will get a sterile syringe and remove urine from the catheter through the collection port to place in the specimen container. " C. "I should collect urine from the catheter drainage bag at the end of the shift and place it in the specimen container. " D. "I will disconnect the drainage tube from the catheter and let urine run from the catheter into the specimen container. " 2. Linda is a 19-year-old primipara who delivered a viable male neonate 2 hours ago. She has decided to breast-feed. Her 22-year-old husband supports her decision. She tells the nurse, "My mother breast-fed all of her children, but I'm going to need lots of help with breastfeeding. I'm worried that I won't be able to do this. " Which of the following should the nurse include when assessing the client? A. Determine the client's level of motivation to breast-feed. B. Perform a complete physical examination to determine her need for help. C. Assess her body-to-fat ratio and nutritional status before beginning...
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...SITUATION : Arthur, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Arthur rushed at the scene. 1. As a registered nurse, Arthur knew that the first thing that he will do at the scene is A. Stay with the person, Encourage her to remain still and Immobilize the leg while While waiting for the ambulance. B. Leave the person for a few moments to call for help. C. Reduce the fracture manually. D. Move the person to a safer place. 2. Arthur suspects a hip fracture when he noticed that the old woman’s leg is A. Lengthened, Abducted and Internally Rotated. B. Shortened, Abducted and Externally Rotated. C. Shortened, Adducted and Internally Rotated. D. Shortened, Adducted and Externally Rotated. 3. The old woman complains of pain. John noticed that the knee is reddened, warm to touch and swollen. John interprets that this signs and symptoms are likely related to A. Infection B. Thrombophlebitis C. Inflammation D. Degenerative disease 4. The old woman told John that she has osteoporosis; Arthur knew that all of the following factors would contribute to osteoporosis except A. Hypothyroidism B. End stage renal disease C. Cushing’s Disease D. Taking Furosemide and Phenytoin. 5. Martha, The old woman was now Immobilized and brought to the emergency room. The X-ray shows a fractured femur and pelvis. The ER Nurse would carefully monitor Martha for which of the following...
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...00_078973706x_fm.qxd 1/14/08 2:42 PM Page i NCLEX-PN ® SECOND EDITION Wilda Rinehart Diann Sloan Clara Hurd 00_078973706x_fm.qxd 1/14/08 2:42 PM Page ii NCLEX-PN® Exam Cram, Second Edition Copyright © 2008 by Pearson Education All rights reserved. No part of this book shall be reproduced, stored in a retrieval system, or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. No patent liability is assumed with respect to the use of the information contained herein. Although every precaution has been taken in the preparation of this book, the publisher and author assume no responsibility for errors or omissions. Nor is any liability assumed for damages resulting from the use of the information contained herein. ISBN-13:978-0-7897-2706-9 ISBN-10: 0-7897-3706-x Library of Congress Cataloging-in-Publication Data Rinehart, Wilda. NCLEX-PN exam cram / Wilda Rinehart, Diann Sloan, Clara Hurd. -- 2nd ed. p. cm. ISBN 978-0-7897-3706-9 (pbk. w/cd) 1. Practical nursing--Examinations, questions, etc. 2. Nursing--Examinations, questions, etc. 3. National Council Licensure Examination for Practical/Vocational Nurses--Study guides. I. Sloan, Diann. II. Hurd, Clara. III. Title. RT62.R55 2008 610.73'076--dc22 2008000133 Printed in the United States of America First Printing: February 2008 Trademarks All terms mentioned in this book that are known to be trademarks or service marks have been appropriately...
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...To me, compulsive overeating is a disease where a person has no control over their food intake. It's a constant eating, a wanting for a more and more. You can't get enough, sort of like a junkie looking for the next high. That is my relationship with food. And I have no control. People that suffer from Compulsive Overeating have what can be labeled not only as an eating disorder, but also as an addiction and even more so as an illness. There are many reasons why people become addicted to food, many using eating as a way to cope with problems or stress in their lives. Eating can also help them conceal their emotions, to fill the emptiness that they feel inside. Food is used as a narcotic to not deal with their feelings or emotions. The tendency for people with this eating disorder is overweight because of the abnormal eating habits. People that do not suffer from the epidemic can and won’t empathize with the victims because of the common stereotypes, stereotype such as greed, gluttony or lack of disciple. Simple suggestions to a sufferer such as “Just slow down or go on a diet” are equally insulting as telling a person suffering from Anorexia to “eat something”. Not only are the words hurtful, but this disorder will negatively bleed into the body and causes health risks. A sufferer with this Compulsive Overeating disorder is prone to high blood-pressure and cholesterol, can develop kidney disease or kidney failure, arthritis, deterioration of the bones, strokes, heart attacks,...
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...NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venous return The most important D: Improve venous return. Elevating the leg both improves venous return and reduces swelling. Client comfort will be improved as well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) B) C) D) Clean the meatus, begin voiding, then catch urine stream Void a little, clean the meatus, then collect specimen Clean the meatus, then urinate into container Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it’s best to just slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) B) C) D) 16 year-old who had an open reduction of a fractured wrist 10 hours ago 20 year-old...
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