NUR 324 Study Guide - Midterm Guide: Hyperosmolar Hyperglycemic State, Serum Albumin, Gastroparesis
14 Nov 2016
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Clients w/ dysphagia enteral nutrition: nasogastric, jejunal, or gastric tubes, nasointestinal, gastrostomy, jejunostomy, peg, pej, 4 levels of diet: Catheter related pneumothorax during cvc placement, air embolus during insertion or when changing tubing or cap (valsalva maneuver in left lateral position during insertion to reduce risk), catheter occlusion, catheter sepsis. Electrolyte imbalance, hypercapnia, hyper/hypoglycemia, hhnkc (hyperglycemic hyperosmolar nonketotic coma), hhns (hyperglycemic nonketotic syndrome) Osmotic diuresis and dehydration from too rapid administration of hypertonic dextrose solution: x-ray to confirm then aspirate gastric contents, hcp secures it and covers w/ sterile dressing, always use infusion pump to deliver at constant rate. Delivers no more than 50% of estimated needs for first 34- 48 hrs. and is gradually increased until needs are met. Tube feedings per ng tube: hob @ minimum of 30 degrees, check placement every 4-6 hrs. in pts. receiving continuous feedings & immediately before feeding pts. receiving intermittent feedings, check gastric residual volume every 4 hrs.
