Question

Document two nursing diagnoses for this patient.

Document your priorities for care of this patient.

Christopher Parrish is an 18-year-old male who was admitted at 1900 today. His mother visited him at his college dormitory and was very concerned with his health; he seemed weak and had lost weight since she last saw him. She took him to see his primary care provider, and the provider admitted him and has ordered a tube feeding. I placed an 8-Fr, 42-inch feeding tube in his right nares about an hour ago, and x-ray just called and confirmed placement in the stomach. The pump is in his room. He is up to the bathroom prn; otherwise bed rest. Christopher was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously. He reports fatigue and has recently lost 6 kg (13.2 lb) after he registered at the local college and moved to live in a dormitory. Chris's mom was here earlier, but she is a single parent and has two younger boys, so she had to go home. Christopher is awake and alert. His heart rate and rhythm are regular at 80–85/min. Breath sounds are fine with a respiratory rate at 18/min. His color is a bit pale. Blood pressure is 118/78 mm Hg. He reports no pain and states he's not had much appetite the past few weeks. His belly is flat and nontender. Bowel sounds are normoactive. Christopher is due for vital signs and assessment. The tube feeding just arrived, and you will need to start it on the pump. He needs 720 kilocalories over 8 hours overnight. His regular diet is high calorie, high fat, but he wasn't too hungry this evening; just had a bit of his chocolate shake. You will need to give his pancreatic enzymes orally before you start the tube feeding. You should also assess his diet and reinforce patient education on nutrition. The scenario is given in SBAR format. Please separate the text into four corresponding sections and be ready to explain the reasoning behind your selection.

Answer 1

The two main nuring diagnosis for this patient are

a) Impaired nutional less than bodys requirement related loss of appetite and impaired absorption of nutrients.

b) Knowledge deficit related to child anf family unfamiliarity with chronic disease management.

2) Priorities of nursing care are

a) Continuosly monitoring the respiratory status.

b) Maintain adequate nutrition by monitoring daily weight, providing tube feeding with feed high in calories, protein and moderate fat.

c) Ensuring the position of tube before each feed.

e) Continuosly assesing the bowel sounds.

f) provide haelth education to the family regarding the all aspects of care of the child.