NURSING QUESTION Scneario: You begin your career in an acute care hospital as a
ID: 122197 • Letter: N
Question
NURSING QUESTION
Scneario:
You begin your career in an acute care hospital as a newly licensed RN. During your orientation, you observe your preceptor checking gastric feeding tube placement by injecting air and auscultating the abdomen, stopping continuous enteral tube feedings before a patient is turned or repositioned, and routinely inserting rectal tubes for patients with diarrhea. You know that ALL three (3) of these practices are currently NOT supported by nursing evidence. When asked, your preceptor responds, "This is the way we have always cared for patients with tube feedings and diarrhea." You prepare to talk to this peer about necessary changes in nursing practice.
Regarding the preceptor's practice of checking gastric feeding tube placement:
1. Describe how you will address this gap in nursing practice with your preceptor.
2. Write out exactly what you might say to this RN to professionally address the current evidence for the nursing care of patients.
3. Include when and where you would communicate this information.
4. Consider any additional information you might provide to your preceptor to support changing this nursing practice.
Thank you.
Explanation / Answer
1. Correct position of the tube must be checked prior to administration of an enteral feed by observing the insertion site at the abdominal wall and looking for any abdominal discomfort.The feed has to be ceased, withdrawing aspirate and testing the pH. Feeds are not recommended if there is any dispute to the position of the tube. Also during feeding, things that are to be checked are taping and any sign of respiratory distress.
2. Enteral feeding tubes should be flushed with water between 5-20 mls of water depending on the viscosity of medication, patient's fluid status balance and size. During feeding, patient must be placed in an upright position to prevent the risk of aspiration.
3. The problems that are to be addressed,its adverse effects and the necessary changes to be followed must be communicated and discussed with senior nursing staff or medical staff.
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