Nursing 400 Final Exam combined study guides quizzes and solutions
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Course
Nursing 400
Institution
Nursing 400
Dysphagia - inability to swallow or difficulty in swallowing
2 key points about Dysphagia - 1. 30 mins prior to meal time, the pt needs to be sitting at 90 degree unless its contraindicated
2. Monitor for possibility of aspiration
-s/s of aspiration
-Coughing
-Wheezing
-Redness of face
-...
Nursing 400 Final Exam combined study
guides quizzes and solutions
Dysphagia - inability to swallow or difficulty in swallowing
2 key points about Dysphagia - 1. 30 mins prior to meal time, the pt needs to
be sitting at 90 degree unless its contraindicated
2. Monitor for possibility of aspiration
-s/s of aspiration
-Coughing
-Wheezing
-Redness of face
-Decrease O2 sat
2 key points about Nasogastric Tube - Used for pt who suffers from
dysphagia (difficulty swallowing)
Residual volume must always be checked q4h d/t risk for aspiration *** if
there is a large amount of residual volume, that means pt is not digesting the
food - inform MD**
Nasogastric Tube Supplies - Nasogastric tube
Irrigation tray - 60 ml syringe
Nursing 400 Final Exam combined study
guides quizzes and solutions
, A bottle of sterile water
lubricant
NGT insertion - 1. Measure the tube from the nose to the back of the ear and
down a little pass the bottom of the xiphoid process
2. Mark the tube (sharpie)
3. Have the patient swallow while inserting the tube (with or without ice
chips)
NGT placement - 1. Once the NGT is inserted, aspirate 30 mL of air
2. Place the stethoscope over the stomach and listen to the "wooooosh"
sound as you inject the air
3. If necessary, get an order for x ray for proper placement.
NGT medication administration - 1. Check if pt is on any fluid restrictions
2. Check gastric residual and put it back after.
Nursing 400 Final Exam combined study
guides quizzes and solutions
, 3. Make sure to kink the tube so that air won't go in the tube (air causes
bloating)
4. Crush medication and mix with water until diluted and poured in the
syringe. [except enteric coated or with granules (Protonix)]
5. Flush 5-10 mL in between medications
6. Flush 30 mL after all medication has been administered
NGT removal - 1. Needs a doctor's order
2. Flush with 10 mL water/NS or 30-50 mL of air
3. Have pt take a deep breath while removing the tube quickly
7 Rules about Body mechanics - -Always bend the knee and have a wide
base for support
-Always point your toes to the direction you're going
-When transferring a patient to a chair or wheelchair, have them hold on to
your shoulders and have your dominant foot in between their legs.
-Always count (1-2-3) out loud and tell them how to position or move
Nursing 400 Final Exam combined study
guides quizzes and solutions
, themselves.
a. If the patient is weaker on one side, have them put their weight on the
stronger side before standing up.
b. Turn your entire body rather than pivoting to avoid hurting your back
-When re positioning the patient, you has always make sure to avoid hurting
your wrists
-Make sure the bed is at your hip level.
-If the patient is too heavy, ask for help.
How do we measure syringe gauge sizes? - THE SMALLER THE
NUMBER, THE BIGGER THE DIAMETER (GAUGE) OF NEEDLE
IV site inspection - look atthe IV catheter insertion site for redness, swelling,
or bruising. Redness can indicate irritation, inflammation, infection, or
thrombus formation. ... Assess the condition of the transparent catheter
dressing. The dressing should be clean, dry, and adhere securely to the skin
around the IV catheter insertion site
Intravenous sites - -Common sites:
Dorsal area of the hands
Forearm
Nursing 400 Final Exam combined study
guides quizzes and solutions
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