Care of Aging Adult II part 3 Flashcards
How should an enteral feeding tube be maintained?
- flushing after feeding and between each medication
- checking gastric residual and pH
- flush every 4 hours unless otherwise instructed
- flush if interruptions in feedings
- flush if not being used (once a day)
What are the complications of enteral feeding?
- aspiration
- erosion of skin near
- clogged tube
- diarrhea
- nausea/ vomiting
- abdominal distention
- stoma infection
- dehydration
What should you do before administering any food, medication or fluids into the enteral feeding tube?
- CHECK TUBE PLACEMENT
- Xray after initial placement or if questions on placement
- measure external length
- pH testing
- aspirate contents
- CO2 monitoring
Safety for enteral feedings:
- check gastric residual before each feeding or every 4-6 hours during each feeding
- high residual increases risk of aspiration, poor GI tolerance
- flush tube with sterile water before and after med administration
- if aspiration is suspected stop immediately
- assess abdomen for abnormalities
- assess lung sounds
- patient must be at a 30 to 45 degree angle at all times during enfeedings and 1 hour after to prevent reflex
- pause feeding when repositioning until bed at least 30 degrees
What are some gerontologic considerations for enteral feedings?
- more vulnerable to complications
- fluid and electrolyte imbalance (hyperglycemia)
- watch closely with diagnosis of HF (((may not tolerate large volumes)
- increase in aspiration
What are some ways to prevent UTI’s?
- hand hygiene
- perineal care
- frequent toileting, fluid intake, shower instead of tub, frequent voiding, void after sex, avoid irritating feminine products
What is the most common pathogen for UTI’s?
E.coli
Explain the pathophysiology of a UTI?
- bacteria must gain access to the bladder
- may result form fecal organisms from perineum to the urethra and bladder
- 3 routes of infection: transurethral, bloodstream, fistula
Clinical manifestations:
symptoms of UTI?
Emptying Symptoms: -dysuria -hesitancy -intermittency -postvoid dribbling -urinary retention or incomplete emptying Storage Symptoms: -incontinence -nocturia -nocturnal enuresis -urgency -urinary frequency
What are the risk factors for UTI?
female diabetes pregnancy neurologic disorders gout incomplete emptying of bladder immunosuppression inflammation/ abrasion of urethra procedures to GU system (catheterization) obstruction poor hygiene
What is the color or smell of a UTI?
- color: dark/ smokey, yellow-brown to olive green, orange-red or orange-brown, cloudiness of freshly voided urine, colorless urine
- odor: ammonia-like or unpleasant odor
What does it mean if the urinalysis is positive for leukocyte esterase or WBC count is high?
inflammation in urinary tract or kidneys. The most common cause for WBC’s in urine (leukocyturia) is bacterial UTI such as a bladder or kidney infection.
What does it mean if the urinalysis is positive for nitrite?
- some bacteria convertes nitrate to nitrite
- a positive nitrite test can indicate UTI
- even a negative test can still be a UTI because not all bacteria converts nitrate to nitrite. This test will be considered along with leukocyte esterase and microscopic evaluation.
What are some older adult risk factors for UTI?
cognitive impairment frequent use of antibiotics multiple chronic medical conditions immunocompromised immobility incomplete emptying of bladder obstructed flow foley catheter
What is different about the older adult and CAUTI?
- older adult may not exhibit typical S/S of infection
- changes in physical condition or mental status must be evaluated for an infection
