Editing Nursing Skills and Procedures – RN Flashcards (section)

== Airway, Enteral, and Injection Skills ==

;What is the gold standard for verifying placement of a newly inserted small-bore feeding tube?
:Radiographic confirmation before first use. Before subsequent feedings, aspirate and check pH, with about 5.5 or lower supporting gastric placement, and compare the external tube length with the documented mark. Auscultation of an air bolus is unreliable and unacceptable.

;What are the current considerations for gastric residual volume?
:Traditional practice holds the feeding for a residual above 500 mL and prompts closer assessment between about 200 and 500 mL. Current critical care guidance discourages routine residual checks as the sole indicator; assess distension, nausea, vomiting, and bowel function as well, and follow facility policy.

;What is refeeding syndrome, and who is at risk?
:A dangerous fall in phosphate, magnesium, and potassium when nutrition is reintroduced to a severely malnourished client, producing cardiac and respiratory failure and arrhythmias. Advance nutrition slowly and monitor electrolytes closely.

;Which oxygen device delivers the most precise concentration, and when is it preferred?
:The Venturi mask, delivering 24 to 60 percent by color-coded adapter. It is preferred when an exact concentration is required, as in chronic obstructive pulmonary disease with a target saturation commonly around 88 to 92 percent.

;What does a fully collapsing nonrebreather reservoir bag indicate, and what is the action?
:Inspiratory demand exceeds delivered flow, so room air is entrained and the delivered concentration falls. Increase the flow rate until the bag remains partially inflated, generally 10 to 15 L/min or higher. Never remove the one-way valves.

;Why is the ventrogluteal site preferred for large volume or viscous intramuscular injections, and how is it located?
:It accommodates up to about 3 mL and is free of major nerves and large vessels. Place the palm on the greater trochanter, the index finger on the anterior superior iliac spine, and the middle finger along the iliac crest, then inject into the V using Z-track technique at 90 degrees.

[[Category:Nursing Skills and Procedures]]
[[Category:Registered Nurse (NCLEX-RN)]]
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