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Zorluk: OrtaBasic Care and Comfort

A nurse is preparing to administer an intermittent bolus enteral feeding via a nasogastric (NG) tube to a client. Arrange the following procedural steps in the correct chronological order from first to last.

  1. 1Elevate the head of the bed to at least 30 to 45 degrees.
  2. 2Verify tube placement and check the gastric residual volume.
  3. 3Flush the nasogastric tube with 30 mL of sterile water.
  4. 4Administer the prescribed enteral feeding formula by gravity.
  5. 5Flush the nasogastric tube with an additional 30 mL of sterile water.

Cevap

The correct sequence for administering an intermittent bolus enteral feeding is to first elevate the head of the bed, followed by verifying tube placement and checking the gastric residual volume. Next, the nurse flushes the tube with water to confirm patency, administers the feeding formula by gravity, and concludes by flushing the tube again to prevent occlusion.
Safe administration of enteral feedings follows a strict sequential protocol. The client must first be positioned upright (30-45 degrees) to prevent aspiration. Once safely positioned, the nurse must confirm the tube is in the stomach and check residual volume to ensure tolerance. A pre-flush verifies patency. After patency is confirmed, the feeding is administered. Finally, a post-flush clears the tube to maintain future patency.

Adım Adım Çözüm

1
Position the client with the head of the bed elevated at least 30 to 45 degrees.
The client is in a semi-Fowler's or high-Fowler's position.
This utilizes gravity to keep gastric contents in the stomach and significantly reduces the risk of pulmonary aspiration.
2
Verify correct tube placement and assess gastric residual volume (GRV).
Tube location in the stomach is confirmed and feeding tolerance is established.
It is a critical safety measure to ensure the formula will not be delivered into the respiratory tract and to verify the client is digesting previous feedings.
3
Flush the tube with 30 mL of sterile water.
The tube's patency is confirmed.
This clears the tube and prepares it for the thicker feeding formula, ensuring there are no blockages.
4
Administer the enteral feeding formula by gravity.
The prescribed nutritional support is delivered.
Gravity allows the formula to flow at a safe, tolerated rate into the stomach.
5
Flush the tube with another 30 mL of sterile water.
The tube is cleared of any residual formula.
Formula left in the tube can coagulate, leading to blockages and bacterial proliferation.

Anahtar Kavram

Safe Enteral Nutrition Administration
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