After providing EN for 24 hours, you receive a new consult to re-evaluate this patient’s feedings. Patient has been having increased residuals of >500mL on multiple occasions throughout the day. Also noted is severe diarrhea that has a foamy/oily appearance and foul odor. Stool studies confirm that this patient has steatorrhea. After retrieval of this patient’s medical record from her primary physician, it is revealed that this patient has a PMH of Crohn’s
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After providing EN for 24 hours, you receive a new consult to re-evaluate this patient’s feedings. Patient has been having increased residuals of >500mL on multiple occasions throughout the day. Also noted is severe diarrhea that has a foamy/oily appearance and foul odor. Stool studies confirm that this patient has steatorrhea. After retrieval of this patient’s medical record from her primary physician, it is revealed that this patient has a PMH of Crohn’s disease and has had multiple intestinal resections in the past.
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What would be your next course of action for this patient? Should we consider PN (explain you’re rational)?
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- 1) The nurse receives an order to administer enteral tube feedings to a client with dysphagia. The order states:Administer 1500 mLs of enteral feeding over 18 hours via infusion pump.What will the mLs per hour be? Round to the nearest whole number. 2) A nurse is caring for a client with a diabetic ulcer which is has a bacterial infection. Identify the lab values the nurse will review to monitor for infectionThe HCP orders Zantac 50 mg IV every 6 hours for ulcers. The pharmacy delivers 25 mg/ml. The nurse will dilute in 50 mL of 0.9% NS to infuse over 30 minutes. No IV pump available. Need to administer via gravity. IV administration set available is a drop factor of 15 What is the rate? Numeric value only.your client was admitted to surgical ward complaining of severe abdominal pain to rule out appendicitis. I.V. fluid NS 2000ml/24 hours was started and kept on I.V Rocephine 2 gm OD. On the 2nd day of I.V therapy, he complained of burning pain along iv site and staff nurse noticed a sluggish flow of IV fluid. His arm looks like the below picture. e Answer Identify the complication of I.V therapy that your cleint has developed. x X, & For the toolbar, press ALT+F10 (PC) or ALT+FN+F1O (Mac). Arial 工 0 Q 14px BIUS Paragraph
- This 58-year-old nuclear power plant worker saw his family physician because of increasing fatigue and weakness. He also reported pain in his lower back and arms when he walks. Physical examination revealed that the man had pale mucous membranes and hepatosplenomegaly. The physician orders a complete blood count (CBC) and urinalysis (UA). A follow-up appointment is scheduled for the following week. Laboratory Data The CBC revealed that the patient had anemia. His leukocyte count and differential count were normal, except for a rouleaux (rolled coin) appearance of the RBCs. The UA was normal. The patient was called and requested to return to the laboratory for additional tests. The physician ordered an ESR, kidney screening profile, liver blood profile, and radiographic skeletal survey, with the following results: ESR—50 mm/hr Kidney profile—normal Liver profile—normal, except for increased globular protein Skeletal survey—bone lesions in various sites What follow-up laboratory tests…A 24 yr old presents in the emergency department with a history of cramping legs and lethargy. On detailed history, the nurse understood that the client is suffering from diarrhea for the last one week. What should the nurse do first? Answer Choices: a. Administer anti-diarrheal medications b. Give IV fluid c. Monitor serum electrolyte d. Collect stool for C/SThe nurse is caring for a 25-year-old patient admitted to the hospital with a diagnosis of pancreatic abscess. The nurse is on high alert, monitoring the patient for systemic inflammatory response syndrome (SIRS). Which order from the health care provider should the nurse perform first? 1. Administer 0.9% normal saline at 150 mL/hr. 2. Administer Ondansetron (Zofran) 4mg IVP for nausea 3. Insert nasogastric tube to intermittent low suction 4. Apply oxygen via nasal cannula to keep O2 saturation 95% and above
- A patient has a fecal impaction. The nurse correctly adminis-ters an oil-retention enema by: a. Administering a large volume of solution (500–1,000 mL)b. Mixing milk and molasses in equal parts for an enemac. Instructing the patient to retain the enema for at least30 minutesd. Administering the enema while the patient is sitting onthe toiletA 39 yearold woman comes to the clinic complaining of diarrhea and abdominal pain. “I feel so weak.” She reports having four to five loose, occasionally bloody stools per day for the past two weeks, with abdominal cramping beginning over the past 48 hours. She has been self-treating with occasional other-the-counter (OTC) antidiarrheals without success. She denies recent antibiotic use. She complains of severe fatigue. She gave birth to her third child 6 weeks ago. She is not breast feeding. A complete blood count, blood chemistry (including electrolytes, renal function tests and blood glucose) and serum iron is ordered along with stool cultures, colonoscopy and upper gastrointestinal (UGI) endoscopy with small bowel follow-through. Lab Data: Sodium 140 mmol/L Potassium 3.5 mmol/L Chloride 105 mmol/L Urea 3.57 mmol/L Serum creatinine 115 µmol/L Glucose 7.8 mmol/L Iron 4.3 µmol/L Hb 132 g/L Hct 0.39 L/L WBC 7.68 x 109 with normal differential She…An old patient suffers from difficulty in evacuation process and lose of weights. During the diagnostic procedures, the physician examine his bowel sounds and identify the presence of mild ascites. He also noted the following symptoms and signs: Phlebitis, Aphthous ulcer, episcleritis and spider naevus. His total bilirubin is 1.5 mg/dl , albumin is 4 g/dl and prothrompine time is 3 sec. laboratory measured In addition, skip lesions between healthy areas diagnosed during the study of the inside of view of the entire colon. A) Calculate and explain the scoring for the Child-Pugh Grading with this case and identify his class. B) Identify the specific types of diseases he is suffering from and the physical examination that used in this case.
- A client admitted for COPD exacerbation is prescribed dexamethasone PO daily for 5 days. Which question is most important for the nurse to ask before giving the first dose? Select one: Oa. "Have you had a fever in the past 72 hours?" Ob. "How would you rate your pain?" c. "Are you having trouble breathing?" d. "When was your last bowel movement?"A 22-year-old comes to the emergency department with light-headedness, diarrhea and fatigue during the past 6 months. She has a 2-year history of gluten-sensitive enteropathy. Her pulse is 100/min. Physical examination shows generalized pallor and glossitis. A peripheral blood smear shows macroovalocytes and hypersegmented neutrophils. Her hemoglobin concentration is decreased, serum homocysteine concentration is increased, and serum methylmalonic acid concentration is within the reference range. This patient most likely has a deficiency of which of the following vitamins? a) Folic acid b) Niacin c) Vitamin B1 (thiamine) d) Vitamin B6 (pyridoxine) e) Vitamin B12 (cobalamin)What is the nursing care plan of the following case scenario? Ms. Dela Cruz, 25 years of age, presents to the triage nurse at the local emergency department complaining of severe generalized abdominal pain. She describes it as sharp and intermittent. She states, “Over the last four (4) days, I haven’t been able to have a bowel movement.” She states that she is able to drink liquids and urinates without difficulty. Bowel sounds are present in all four (4) quadrants, however, they are hypoactive (decreased or quiet peristalsis). Abdomen is distended and firm to touch. She states, “Two weeks ago I feel that my back hurts. My doctor gave me a prescription of Tylenol #3 and I have been taking it every 6 hours for pain.” She denies pain at the present time. Abdominal x-ray reveals a large amount of stool in her lower colon. All other diagnostic tests are unremarkable. Assessment Diagnosis Goal/Object goal Planning Intervention Rationale Evaluation Objective data: Subjective data:…