5.7 Learning Activities

Case Study #1

Caroline, age 92, visits her health care provider for a follow-up visit with her son Brian. You take Caroline’s vitals prior to the visit and find her to be hypotensive and bradycardic. She is slow to respond to questions, and Brian answers most of the questions you have for her. Brian says, “I’m worried about mom; that’s why I asked for this appointment. I haven’t seen her since Christmas two weeks ago, but she looks as if she has withered away to nothing in that time.”

You note that since her last visit six months ago, she has had a 20-pound weight loss, and her BMI today is 16.2. Caroline lives alone in an apartment in an assisted living facility; her husband passed five years ago. Brian is her only child.

Brian states, “I thought she was doing so well. I haven’t been told that she wasn’t eating, but when I visited yesterday, she refused to eat any lunch or dinner, and only ate a half piece of toast at breakfast.”

When you ask Caroline how she’s feeling, she says, “I just don’t feel like eating anymore. I know that I’m healthy, but my appetite is not there. I’m not ready to give up.” She smiles, “I’m still a feisty 92 years young.”

Caroline’s health care provider admits her to the hospital to start NG tube feedings.

1. What can you provide for client education regarding the NG tube?

2. What are the maintenance care priorities for care of the NG tube?

3. Are there any specific concerns related to Caroline’s need for an NG tube that should be monitored or addressed?  What will you consider as you prepare for placement of the NG tube?

4. What is the purpose of the NG tube?

5. How often should an NG tube be assessed?

6. What cues would indicate further assessment of the NG tube and the client?

7. What type of technique is used to insert the NG tube?