question archive Christopher Parrish vSim Documentation Assignments Situation: Christopher Parrish is an 18-year-old male who was admitted at 1900 today
Christopher Parrish vSim Documentation Assignments Situation: Christopher Parrish is an 18-year-old male who was admitted at 1900 today
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Christopher Parrish vSim Documentation Assignments Situation: Christopher Parrish is an 18-year-old male who was admitted at 1900 today. His mother visited him at his college dormitory and was very concerned with his health; he seemed weak and had lost weight since she last saw him. She took him to see his primary care provider, and the provider admitted him and has ordered a tube feeding. I placed an 8-Fr, 42-inch feeding tube in his right nares about an hour ago, and x-ray just called and confirmed placement in the stomach. The pump is in his room. He is up to the bathroom prn; otherwise bed rest.
Background: Christopher was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously. He reports fatigue and has recently lost 6 kg (13.2 lb) after he registered at the local college and moved to live in a dormitory. Chris's mom was here earlier, but she is a single parent and has two younger boys, so she had to go home.
Assessment: Christopher is awake and alert. His heart rate and rhythm are regular at 80-85/min. Breath sounds are fine with a respiratory rate at 18/min. His color is a bit pale. Blood pressure is 118/78 mm Hg. He reports no pain and states he's not had much appetite the past few weeks. His belly is flat and nontender. Bowel sounds are normoactive.
Recommendation: Christopher is due for vital signs and assessment. The tube feeding just arrived, and you will need to start it on the pump. He needs 720 kilocalories over 8 hours overnight. His regular diet is high calorie, high fat, but he wasn't too hungry this evening; just had a bit of his chocolate shake. You will need to give his pancreatic enzymes orally before you start the tube feeding. You should also assess his diet and reinforce patient education on nutrition.
1. Document your focused gastrointestinal and dietary assessment of Christopher Parrish.
2. Document two nursing diagnoses for this patient.
3. Document your priorities for care of this patient.
4. Describe the age-related considerations you will use when caring for Christopher Parrish.
5. Referring to your feedback log, document the nursing care, including patient education about nutritional needs and therapy, which you provided to Christopher Parrish. Include his response.
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1) Focused gastrointestinal and dietary assessment of Christopher Parrish includes:
- Interview of his mother to collect information about his appetite, respiratory infection, and family history of cystic fibrosis
- Assess the knowledge of his mother about his condition
- Proper vital signs assessment including cough, respiration, barrel chest, and other signs observation
- Assess the skin of rectum and surrounding area
2) Nursing diagnosis for Christopher includes:
- Aspiration risk due to the administration of enteral feeding and feeding tube
- The respiratory situation may lead to activity risks
3) Priorities for care of this patient:
- Fluid nutrition administration as prescribed
- Medication administration as prescribed
- Assessment of vitals and gastrointestinal condition
- Anxiety is removed as directed
4)
- Fulfill the nutritional deficiency of the patient as he is constantly losing weight. Provide a diet in a feeding tube that is of high calories
- Report any alteration in bowel movements during initial treatment
- Provide proper education to the mother related to care and management
5) Patient education:
- Provide a need-based diet plan with the addition of pancreatic enzymes to aid digestion
- Give pancreatic enzymes to the patient as prescribed
- Refer the patient to a nutritionist to remove any deficiency
- Monitor the weight of patient regularly
