Situation: Christopher Parrish is an 18-year-old male who was admitted at 1900 today. s 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. Background: 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. ChrisΒs mom was here earlier, but she is a single parent and
has two younger boys, so she had to go home. Assessment: Christopher is awake and alert. s heart rate and rhythm are regular at 80-85/min. Breath sounds are fine with a respiratory rate at 18/min. s color is a bit pale. Blood pressure is 118/78 mm Hg. He reports no pain and states heΒs not had much appetite the past few weeks. s belly is flat and nontender. Bowel sounds are normoactive. Recommendation: 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. s regular diet is high calorie, high fat, but he wasnΒt 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.