Assignments,Question and answers Christopher Parrish Documentation ,100% CORRECT

1. Document your focused gastrointestinal and dietary assessment of Christopher Parrish. o Vital signs o Inspect abdomen and auscultate bowel sounds o Palpate abdomen and question about last bowel movement o Inspect NGT tubing on the outside and assess placement via checking mouth and inspect nares as well o Aspirate NGT for placement inspection and flush o Ask patient’s eating habits and understanding of diet order o Keep patient in semi or full fowlers position to reduce risk of aspiration o Find out what patient knows about aspiration risk and educate as need o Administer medication o Administer fluid 2. Document two nursing diagnoses for this patient. • Risk for aspiration as evidenced by NGT • Impaired nutrion lower that body requirerment r/t disease and evidenced by loss of appetite and weight loss 3. Document your priorities for care of this patient. • Obtain vital signs and assessment of abdomen and NGT • Continuous respiratory status monitoring • Maintain adequate nutrition by ensuring proper tube feeding is provided • Administer prescribed medications as ordered • Assessing tube correct tube placement before meals • Assess bowel sounds continuously • Provide required education of diet, aspiration and NGT as needed 4. Describe the age-related considerations you will use when caring for Christopher Parrish. o Establishing independence is important at this age so I will allow for chris to participate o Reinforce patient education about nutritional intake, BMI, and I&O o Ensure patients understanding of feeding process and risk for aspiration 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. • Educated about I&O • Educated about BMI • Educated about diagnostics • Educated about tube feeding • Educated about aspiration Christopher Parrish Guided Reflection Questions Opening Questions How did the simulated experience of Christopher Parrish’s case make you feel? It was an interesting way to learn more on how assessing a patient and dealing with a patient will be like in the real world. I think it is a great starting point to get a better feel for it and see all the different things involved prior to dealing with actual patients. Talk about what went well in the scenario. Was able to assess patient and find out patient’s history as well was able to successfully administer fluids. Reflecting on Christopher Parrish’s case, were there any actions you would do differently if you were to repeat this scenario? If so, how would your patient care change? Be more through even if it takes longer to ensure nothing is being missed. Scenario Analysis Questions PCC What priority problem(s) did you identify for Christopher Parrish? • Poor nutrition due to cystic fibrosis • Possible safety concerns r/t NGT PCC What potential problems could arise due to Christopher Parrish’s identified Vitamin D deficiency? • Hypocalcemia can develop that could eventually result in osteoporosis PCC Discuss the relationship between pancreatic enzymes, malabsorption, and CF. • Cystic fibrosis causes a loss of pancreatic enzymes which results in malabsorption of vitamins such as vitamin D. PCC/S/EBP What are important assessments related to administration of enteral feedings? • Ensure properly anchored and placed by aspirating prior to each meal PCC/T&C Using Erikson’s developmental stages,discuss the importance of peer relationships/support group with other young adults with cystic fibrosis. • Christopher is a young adult according to Erikson is “Intimacy vs. Isolation” and there for it is vital for him to obtain and maintain healthy emotional relationships. It would be best to encourage him to reach out and participate in support groups. S/EBP Identify potential patient safety issues related to nutritional status in the care of Christopher Parrish. • Since patient has CF and pancreatic enzymes are not working as would normally it would be beneficial to give pancreatic enzymes prior to meals to assist in digestion and absorption of nutrients. T&C What other interprofessional team members should be involved in Christopher Parrish’s care? • Dietitian • Case Management • Social Services • Respiratory therapist Concluding Questions Describe how you would apply the knowledge and skills that you acquired in Christopher Parrish’s case to an actual patient care situation. Always takes the patients individual needs and customs into consideration first and foremost. Figure out the patients current understand of their condition and provide adequate education on any topic where there is lack of understanding. Reiterate the importance of monitoring I&O and taking vitamins and medications as prescribed.