The client’s family member should be taught to flush the tube after each feeding and clamp the tube. PEG stands for percutaneous endoscopic gastrostomy, a procedure in which a flexible feeding tube is placed through the abdominal wall and into the stomach. PEG allows nutrition, fluids and/or medications to be put directly into the stomach, bypassing the mouth and esophagus.

Option B: A dressing will be placed on the PEG site following the procedure. This dressing is usually removed after one or two days. After that you should clean the site once a day with diluted soap and water and keep the site dry between cleansings. No special dressing or covering is needed.
Option C: The placement should be checked before feedings, and indigestion can occur with the PEG tube, just as it can occur with any client. Complications can occur with the PEG placement. Possible complications include pain at the PEG site, leakage of stomach contents around the tube site, and dislodgement or malfunction of the tube. Possible complications include infection of the PEG site, aspiration (inhalation of gastric contents into the lungs), bleeding and perforation (an unwanted hole in the bowel wall).
Option D: Medications can be ordered for indigestion, but it is not a reason for alarm. A percutaneous endoscopic gastrostomy tube is used for clients who have experienced difficulty swallowing. The tube is inserted directly into the stomach and does not require swallowing.

The client with a total knee replacement should be assessed for anemia. A hematocrit of 26% is extremely low and might require a blood transfusion. Results from a hematocrit test are reported as the percentage of blood cells that are red blood cells. Normal ranges vary substantially with race, age, and sex. The definition of normal red-blood-cell percentage also varies from one medical practice to another.

Option A: Bleeding of 2cm on the dressing is not extreme. Circle and date and time the bleeding and monitor for changes in the client’s status. Healthline analyzed data on over 1.5 million Medicare and privately insured people to take a closer look. They found that 4.5 percent of people who are aged under 65 experience complications while in the hospital after a knee replacement.
Option B: A low-grade temperature is not unusual after surgery. Ensure that the client is well hydrated, and recheck the temperature in 1 hour. If the temperature is above 100.6°F (38.1°C), report this finding to the doctor. Tylenol will probably be ordered. Infections are rare after knee replacement surgery, but they can occur. Infection is a severe complication, and it needs immediate medical attention.
Option D: Voiding after surgery is also not uncommon and no need for concern. In rare cases, a person may have osteolysis. This is inflammation that occurs due to microscopic wear of the plastic in the knee implant. The inflammation causes bone to essentially dissolve and weaken.

Plumbism is lead poisoning. One factor associated with the consumption of lead is eating from pottery made in Central America or Mexico that is unfired. The child lives in a house built after 1976 (this is when lead was taken out of paint), and the parents make stained glass as a hobby. Stained glass is put together with lead, which can drop on the work area, where the child can consume the lead beads.

Option A: Traveling out of the country does not increase the risk of plumbism. Because lead is not biodegradable, it demonstrates remarkable environmental persistence. Despite the fact that the amount of lead in paint intended for use in or on residential buildings, furniture, or children’s toys in the United States has been restricted to 0.06% since 1978 and was further reduced to 0.009% in 2008, lead-based paint continues to be a major source of lead exposure in young children.
Option C: The house was built after the lead was removed with the paint. Several million young children in the United States live in older homes in which lead-based paint was previously used, and as this old paint ages, it peels, flakes, and crumbles into dust that settles on the interior surfaces of homes and in the soil surrounding the exterior of the home. The dust and soil containing these tiny paint particles inevitably make their way into children’s mouths as a result of normal childhood exploratory hand-to-mouth behavior.
Option D: Having several siblings is unrelated to the stem. A variety of occupations and hobbies may expose adults to lead, and working parents may inadvertently bring lead home where they can expose their children second-hand. Some of the highest risk occupations and hobbies include metal welding, battery manufacturing, and recycling, shipbuilding and shipbreaking, firing range use or instruction as well as bullet salvaging, lead smelting and refining, painting and construction work, and pipefitting and plumbing.

The equipment that can help with activities of daily living is the high-seat commode. The hip should be kept higher than the knee. There is also equipment available for patients to help them follow their newly prescribed hip precautions. Some patients purchase raised toilet seats and chairs to prevent them from bending at the hip more than 90 degrees.

Option B: The recliner is good because it prevents 90° flexion but not daily activities. Sock aids and dressing sticks are often used to make dressing and changing clothing easier for the patient. Reachers or “pinchers” can also be used by a patient following a total hip arthroplasty to help them grab items from the ground and other areas without breaking the hip precautions.
Option C: A TENS (Transcutaneous Electrical Nerve Stimulation) unit helps with pain management. Compliance with hip precautions can be challenging for patients to follow. Many activities that were once simple to perform are instantly complicated. Activities of daily living can be significantly affected. Examples of activities of daily living include bathing, grooming, dressing, toileting, and transferring. Lack of independence can leave patients very upset and disheartened further affecting the rate of compliance.
Option D: An abduction pillow is used to prevent adduction of the hip and possibly dislocation of the prosthesis. There are also environmental modifications that can help prevent hip dislocations; these include removing all tripping hazards from home, moving around the layout of home furniture so that there are fewer turns, and installing grab rails around the house.

Narcan is the antidote for narcotic overdose. Naloxone is indicated for the treatment of opioid toxicity, specifically to reverse respiratory depression from opioid use. It is useful in accidental or intentional overdose and acute or chronic toxicity. Common opioid overdoses treated with naloxone include heroin, fentanyl, carfentanil, hydrocodone, oxycodone, methadone, and others.

Option A: If hypoxia occurs, the client should have oxygen administered by mask, not cannula. The incidence of naloxone-induced noncardiogenic pulmonary edema is estimated to be between 0.2% and 3.6% of patients who have received naloxone and are transported to the emergency department. Symptoms include persistent hypoxia, despite the resolution of respiratory depression secondary to acute overdose. Patients may also have a cough productive of the classic “pink, frothy sputum” indicative of pulmonary edema.
Option C: In chronic opioid users, naloxone requires slow administration to individuals who are dependent on opioids. All patients who have responded to naloxone should be continuously monitored for at least six to 12 hours since some opioids (methadone, fentanyl, buprenorphine) have a much longer half-life than naloxone.
Option D: There is no data to support cardiac resuscitation in this case. The patient should have vital signs, including pulse oximetry, monitored until obtaining a full recovery. Even after reversing respiratory depression, the patient must be monitored for at least six to 12 hours because the patient may have ingested the longer-acting opioids, which will continue to exert their effects after excretion of the naloxone. Any patient that requires IV naloxone of doses more than 5 mg should be admitted.