NUR 104 EXAM 4 CORE COMPLEX PATIENT
CARE AND CLINICAL DECISION MAKING
REVIEW 2026
◉ Teaching plan for a patient scheduled for an endoscopic
retrograde Cholangiopancreatography (exam of the liver, gallbladder
, bile ducts, and pancreas.).
Answer: NPO before the procedure.
Inquire about previous exposure to contrast media and sensitivities
or allergies
Sedation is administered before the procedure.
avoid anticoagulants, aspirin or NSAIDs, for several; days
◉ Procedure of inserting a nasogastric tube.
Answer: Measure from ear to chin to xiphoid process. Chin to neck
position. Have the patient swallow as you place to help move it down
the esophagus.
◉ Positioning of a patient with a nasogastric tube.
Answer: Elevate head 45-90 degrees if possible.
◉ Nursing care for a patient with a nasogastric tube for
decompression.
, Answer: Provide nare care, oral care, ensure patency, secure the line.
Use intermittent suction. Administer saline flushes every 8 hours.
Maintain NPO
◉ Difference between patients receiving tube feeding and total
nutrition.
Answer: Tube feeding is for patients with normal bowel function.(
can be used for an extended amount of time)
Total parenteral nutrition (TPN) is used for patients unable to
metabolize foods, due to lack of bowel function. (should be used
short term)
◉ Risk factors for the patient receiving total parenteral nutrition.
Answer: Hyperglycemia, blood glucose checks every 6 hours, risk for
infections, tubing change every 24 hours.
Watch for the 3 p's (polyphagia, polydipsia, polyuria)
Risk for infection, replace tubing and TPN every 24 hrs
◉ Nurses' steps for administering a continuous and intermittent
tube feeding.
Answer: Inspect and Auscultate the abdomen.
Ensure placement by pulling residual and testing for pH level
(should be acidic).
CARE AND CLINICAL DECISION MAKING
REVIEW 2026
◉ Teaching plan for a patient scheduled for an endoscopic
retrograde Cholangiopancreatography (exam of the liver, gallbladder
, bile ducts, and pancreas.).
Answer: NPO before the procedure.
Inquire about previous exposure to contrast media and sensitivities
or allergies
Sedation is administered before the procedure.
avoid anticoagulants, aspirin or NSAIDs, for several; days
◉ Procedure of inserting a nasogastric tube.
Answer: Measure from ear to chin to xiphoid process. Chin to neck
position. Have the patient swallow as you place to help move it down
the esophagus.
◉ Positioning of a patient with a nasogastric tube.
Answer: Elevate head 45-90 degrees if possible.
◉ Nursing care for a patient with a nasogastric tube for
decompression.
, Answer: Provide nare care, oral care, ensure patency, secure the line.
Use intermittent suction. Administer saline flushes every 8 hours.
Maintain NPO
◉ Difference between patients receiving tube feeding and total
nutrition.
Answer: Tube feeding is for patients with normal bowel function.(
can be used for an extended amount of time)
Total parenteral nutrition (TPN) is used for patients unable to
metabolize foods, due to lack of bowel function. (should be used
short term)
◉ Risk factors for the patient receiving total parenteral nutrition.
Answer: Hyperglycemia, blood glucose checks every 6 hours, risk for
infections, tubing change every 24 hours.
Watch for the 3 p's (polyphagia, polydipsia, polyuria)
Risk for infection, replace tubing and TPN every 24 hrs
◉ Nurses' steps for administering a continuous and intermittent
tube feeding.
Answer: Inspect and Auscultate the abdomen.
Ensure placement by pulling residual and testing for pH level
(should be acidic).
