NG Tube Insertion-     List the supplies needed for an NG tube insertion.   How is placement verified and what is the most accurate method to determine placement?     Match the pH test result to the likely source 1 to 4   5 or higher      Greater than 6     Stomach of a fasting patient Patient with continuous tube feeding Pleural fluid from the tracheobronchial tree Intestine of a fasting patient     Administering Enteral Nutrition: Nasoenteric, Gastrostomy, or Jejunostomy tube   What are the indications for enteral nutrition?   Describe the assessment and nursing interventions to ensure safe care for clients with intermittent or continuous enteral tube feeding:  prior to, during, and after feeding.   What are the types of enteral feeding tubes, the placement, and the purpose(s) of each?   What are the different types of enteral nutrition formulas?     Identify complications with enteric tubes, possible causes, and nursing interventions to deal with these complications Problem Cause Intervention Pulmonary aspiration       Diarrhea       Constipation       Tube occlusion       Tube displacement       Abdominal cramping, nausea, or vomiting     Delayed gastric emptying     Serum electrolyte imbalance     Fluid overload     Hyperosmolar dehydration         Feedings may be given either as a Bolus or intermittent feeding or via continuous drip method. What is the recommended flow rate in ml/hr. when the feeding is bein6. g given by the continuous method?     Case Studies   Mrs. Rogers is a 45-year-old woman who is on your long term care floor.  She was admitted after a prolonged cardiac arrest and subsequent brain damage.  She is receiving enteral feedings through a PEG tube.  You enter the room to do the morning care, you find her in a supine position with her feedings infusing.  She appears to be having some difficulty breathing.  What are your initial actions?  What do you think has happened and how would you prevent this situation in the future?       You are caring for Mrs. Rogers (above) and need to administer her medications via her PEG tube.  You have the following medications to administer:   Tylenol elixir 600 mg Q6H Colace elixir 100 mg BID Coversyl 4mg daily Pantoprazole 40mg daily Enteric coated ASA 81mg daily Lasix 40mg daily Potassium chloride 20 mmol daily Metoprolol 25mg daily Glyburide 5 mg BID   The nurse told you to crush all the meds, put them in a cup and dilute with 20ml of water.  You are uncertain as to this protocol. Based on this information, do you have any concerns about the types of medications? How should you administer these medications?    Gladys, an 84-year-old-widow, is close to being discharged from outpatient services after breaking her hip from a fall. She uses alchoho, and tells you that she has been drinking more heavilty since her husband passed away more than a year ago to help her cope with grief. She won't tell you how often or how much she drinks, but admits that she's lost over 25 pounds in the past year.    How do you establish a therapeutic relationship with Gladys?   What support can you provide for Gladys?   What are some key risk considerations?   What are the key medication considerations, especially given her age and alcohol use?   What other considerations may you have to consider to maintain her safety?