Problem 1: A nurse inserting a nasogastric tube in a client must ascertain whether the tube at its final mark is located within the stomach. During the process, the client belches. Later during the process, the client's aspirated fluid appears clear, brownish-yellow.
a. How will the nurse understand the client's belching?
b. How will the nurse interpret the color of the aspirated fluid?
c. How should the nurse ensure the most accurate assessment of the location of the tube's distal tip?
Problem 2: An 85-year-old client is unable to eat due to a depressed gag and swallow reflex as a result of a recent stroke. The nurse has to administer tube feedings through a gastrostomy tube. The nurse has to assess for gastric residual before beginning the ordered schedule for administering the tube feeding.
a. The nurse is reviewing the client's orders for the scheduled tube feeding administration. The orders are for a continuous tube feeding schedule. What does the nurse have to know about a continuous tube feeding schedule?
b. What daily assessments must the nurse complete for this client who is receiving the tube feeding?
c. Why does the nurse have to assess for gastric residual?