Responsibilities for maintaining tube feeding

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Reference no: EM133920602

Question

Part 1.

You are caring for Mr. Rich Johnson, a 32-year-old admitted to your acute care nursing unit after following a bike crash that occurred during triathlon competition two weeks ago. He sustained a closed head injury and now has altering levels of consciousness with Glasgow Coma Scale scores averaging 10 to 11. Mr. Johnson sustained a fracture to his right femur and tibia and to the right radius. The leg fracture sites were stabilized with an external fixation device and his right arm is in a cast and can bend his right elbow. These will be in place for at least six weeks. On his right thigh, Mr. Johnson has a wound that requires a sterile dressing change. He is currently in bed and does not move himself spontaneously. He has an indwelling urinary catheter in place and is receiving tube feeding at 60 ml/hour.

1. Complete the chart below:

Body System Effects of Immobility What should you plan to do?

Musculoskeletal

Pulmonary

Cardiovascular

Metabolic

Integumentary

(Skin)

Gastrointestinal

Genitourinary

Psychological

2. Describe your responsibilities for maintaining the tube feeding for Mr. Johnson. Consider all aspects of the care plan.

3. What would you include in Mr. Johnson's plan of care related to the indwelling urinary catheter?

4. Describe the plan of care you will create for Mr. Johnson's hygiene. What is the rationale for your actions?

5. What are some of the complications related to Mr. Johnson's ability to rest and to sleep? list three nursing interventions that you would include in the plan of care to promote rest and sleep.

6. Describe the equipment needed and nursing considerations that you would include for the sterile dressing change.

Part Two:

Mr. Johnson has regained consciousness and you have just removed his urinary catheter. The provider wrote an order to "D/C NG tube". Mr. Johnson tells you that he wants to reposition himself in the bed. The provider wrote orders for "OOB to chair for all meals, no weight bearing right leg" and "May ambulate to BR with assistance, instruct on use of walker".

6. Keeping in mind Mr. Johnson's injuries, what kind of repositioning devices would be appropriate for him to use?

7. Mr. Johnson wants to get OOB as soon as possible. You sit him on the side of the bed, but he states that he feels "woozy and nauseated." What is happening and how will you intervene?

8. Describe your nursing responsibility after the removal of the urinary catheter.

9. During the morning assessment, Mr. Johnson states "I just don't know how I will ever recover from this- I can't do anything for myself. I am so used to training every single day and now I can't do anything I would call exercise. How can I get ready for all this rehab work?" What type of exercise would you recommend for this client to regain muscle strength?

Reference no: EM133920602

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