The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [302]
a The feed.
b An infection.
c Food poisoning.
d Being in hospital.
6 Your patient has a bulky oesophageal tumour and is waiting for surgery. When he tries to eat, food gets stuck and gives him heartburn. What is the most likely route that will be chosen to provide him with the nutritional support he needs?
a Nasogastric tube feeding.
b Feeding via a percutaneous endoscopic gastrostomy (PEG).
c Feeding via a radiologically inserted gastrostomy (RIG).
d Continue oral food.
7 What is the best way to prevent a patient who is receiving an enteral feed from aspirating?
a Lie them flat.
b Sit them at least at a 45° angle.
c Tell them to lie on their side.
d Check their oxygen saturations.
8 Which of the following medications are safe to be administered via a nasogastric tube?
a Enteric-coated drugs to minimize the impact of gastric irritation.
b A cocktail of all medications mixed together, to save time and prevent fluid overloading the patient.
c Any drugs that can be crushed.
d Drugs that can be absorbed via this route, can be crushed and given diluted or dissolved in 10–15 mL of water.
9 Which check do you need to carry out before setting up an enteral feed via a nasogastric tube?
a That when flushed with red juice, the red juice can be seen when the tube is aspirated.
b That air cannot be heard rushing into the lungs by doing the ‘whoosh test’.
c That the pH of gastric aspirate is <5.5, and the measurement on the NG tube is the same length as the time insertion.
d That pH of gastric aspirate is >6.0, and the measurement on the NG tube is the same length as the time insertion.
10 Fred is going to receive a blood transfusion. How frequently should we do his observations?
a Temperature and pulse before the blood transfusion begins, then every hour, and at the end of bag/unit.
b Temperature, pulse, blood pressure and respiration before the blood transfusion begins, then after 15 minutes, then as indicated in local guidelines, and finally at the end of the bag/unit.
c Temperature, pulse, blood pressure and respiration and urinalysis before the blood transfusion, then at end of bag.
d Pulse, blood pressure and respiration every hour, and at the end of the bag.
Answers to the multiple choice questions can be found in Appendix 3.
These multiple choice questions are also available for you to complete online. Visit www.royalmarsdenmanual.com and select the Student Edition tab.
Chapter 9
Patient Comfort
Overview
The aim of this chapter is to present the many varied procedures that contribute towards the comfort of patients at all times. This ranges from the very specific procedures that are involved in pain management to those that promote comfort from a wider perspective, such as personal hygiene. In ensuring patient comfort, it is necessary to consider aspects of any procedure from the preplanning stage to the return of the patient to their preprocedure position.
Comfort will mean different things to different patients. It may involve being in a relaxed state free from pain, disappointment or perhaps satisfaction or physical well-being provided by another person. For the nurse, aspects of care to be considered include discussions prior to undertaking the procedure, gaining consent, ensuring pain control and maintaining privacy and dignity, offering mouthcare as well as paying attention to the patient’s immediate environment.
Personal hygiene
Definition
Good ‘personal hygiene is imperative for individuals’ health and wellbeing’ (Pegram et al. 2007, p.356). It is the physical act of cleaning the body to ensure that the skin, hair and nails are maintained in an optimum condition (DH 2001).
Anatomy and physiology
Skin
A definition of healthy skin is that it is fulfilling all of its functions, so an individual’s quality of life is not adversely affected (Penzer and Finch 2001). Being the largest organ of the body, maintaining