NUR280 COMP 1 REVIEW LATEST UPDATED 2022 ALREADY GRADED A

NUR 280- COMP ONE REVIEW  Peg tube- what do peg feed bags and TPN tubing have in commono Tubing and bags must be changed every 24 hours o Refeeding syndrome- occurs when feeding is restarted for a client that is in a ...

NUR 280- COMP ONE REVIEW  Peg tube- what do peg feed bags and TPN tubing have in commono Tubing and bags must be changed every 24 hours o Refeeding syndrome- occurs when feeding is restarted for a client that is in a starvation state.  The electrolyte shift of refeeding syndrome can cause cardiovascular, respiratory, and neurological problems, primarily as a result of hypophosphatemia. Watch for shallow respirations, weakness, acute confusion, seizures and increased bleeding tendency. Report and document findings immediately!  What are some nursing interventions to take regarding feeding through a peg? o Flush the tube with 20-30 mL of water (whatever is prescribed)  At least every 4 hours during a continuous tube feed  Before and after each intermittent tube feeding  Before and after drug administration- use warm water o If the tube becomes clogged, use 30mL of water for flushing, applying gentle pressure with a piston syringe o Avoid the use of carbonate beverage, except for existing clogs when water isn’t effective. Don’t use cranberry juice o Whenever possible, use liquid medications instead of crushed tablets unless liquid forms cause diarrhea. Make sure drugs are compatible with feeding solutions o Don’t mix drugs with the feeding product before giving. Crush tablets are finely as possible, and dissolve in warm water o Consider use of automatic flush feeding pump like kangaroo.  If enteral tubes are misplaced or become dislodged, the patient is likely to aspirate. Aspiration pneumonia is a life-threatening complication associated with TEN, especially for older adults. Observe for increasing temperature and pulse, as well as for other signs of dehydration such as dry mucous membranes and decreased urinary output. Auscultate lungs every 4-8 hours to check for diminishing breath sounds, especially lower lobes. A chest x-ray confirms this diagnosis and antibiotics are started for treatment.  How do you check placement of an NG tube? o pH of stomach contents- less than 4 o and then go down for x-ray- number one indicator! o do not inject air to check placement!!!  Know the difference between expected findings and unexpected findings! - as far as priority o ABCs!!!! o “new onset of”, “acute onset”, “suddenly”, “new development of”  THAT IS YOUR PRIORITY!!!  Know the difference between right sided and left sided heart failure! o Right- JVD, pitting edema, ascite- systemic congestions o Left- crackles, pink frothy sputum, pulmonary edema- pulmonary congestion o Daily weight is the best indication of heart failure- weigh after unirnating in the morning, wearing the same clothes, at the same time. o BNP is used to track heart failure  Understand normal growth and development in children and know normal vital signs in children o Heart rate:  New born- 80-180 bpm (depending on activity)  1 week-3 months- 80-220 bpm (depending on activity)  3 moths- 2 years- 70-150 bpm (depending on acivity)  2-10 years old- 60-110 bpm (depending on activity)  10+ years- 50-90 bpm (depending on activity) o respirations  newborn-1 year- 30-35 breaths/min  1-2 years- 25-30 breaths/min  2-6 years- 21-25 breaths/min  6-12 years- 19-21 breaths/min  12+ years older- 16-19 breaths/min o blood pressure: Age Systolic Pressure Diastolic Pressure Systolic Hypotension Birth (12 h, <1000 g) 39­59 16­36 <40­50 Birth (12 h, 3 kg) 60­76 31­45 <50 Neonate (96 h) 67­84 35­53 <60 Infant (1­12 mo) 72­104 37­56 <70 Toddler (1­2 y) 86­106 42­63 <70 + (age in years x 2) Preschooler (3­5 y) 89­112 46­72 <70 + (age in years x 2) School­age (6­9 y) 97­115 57­76 <70 + (age in years x 2) Preadolescent (10­11 y) 102­120 61­80 <90 Adolescent (12­15 y) 110­131 64­83 <90 o Know what toys/activities would be appropriate for the different ages o Know how they communicate, know how they play! o You will pretty much only explain a procedure to an adolescent child