Skip to content
View in the app

A better way to browse. Learn more.
allnurses

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
Discussion

Paralytic Ileus

Patient has been diagnosed with Ileus post obstruction. Pt has chronic low intestinal motility secondary to bilateral schizencephaly: quadraplegic spasticity. High metabolism requiring high caloric diet. Pt has JG. Pt is now receiving small amount JG feed: initiated in last 24 hours. 3am patient vomits large amount green bile...Resident comes in the morning to inform family that they are considering advancing patient from clear liquid diet to full liquid diet. I am questioning the appropriateness of this diet advancement. Does any one have some specific feedback?

  • Quote

    • Featured Replies

    Did you ask the resident who proposed the diet change?

    Or is this homework you're wanting us to complete for you?

  • Quote
    • Author

    The resident was proposing the change: Let's just say: it didn't happen. And, the family has asked that no other residents be a part of this patients care. Many other factor's involved: the family is requesting only doctor's and at this point due to other circumstances, specialists are needing to get involved.

    As far as the homework, no.....I have that information. Thanks.

  • Quote

    A couple of general points:

    "No more residents/students" is a common, understandable reaction on the part of family who are frightened of a patient's condition, or in denial about the chronicity of a patient's morbidities. It very often is not an accurate reflection of the quality of care actually provided by those members of the team.

    In the last several years I have seen a shift towards tolerance of greater residuals, and, in simple terms, making sure that we are giving our patients adequate nutrition - not overreacting to every episode of vomiting.

    And you know that residents are doctors, right? ;)

  • Quote
    • Experts
    A couple of general points:

    "No more residents/students" is a common, understandable reaction on the part of family who are frightened of a patient's condition, or in denial about the chronicity of a patient's morbidities. It very often is not an accurate reflection of the quality of care actually provided by those members of the team.

    In the last several years I have seen a shift towards tolerance of greater residuals, and, in simple terms, making sure that we are giving our patients adequate nutrition - not overreacting to every episode of vomiting.

    And you know that residents are doctors, right? ;)

    new, inexperienced doctors
  • Quote
    • Author

    (smirk smirk) yes, I know what residents are...... This patient will be going for further GI evaluation. Actually the care by the primary team members is not in question.

  • Quote

    • Join the conversation

    You can post now and register later. If you have an account, sign in now to post with your account.

    Guest
    Add a Comment
    Go to topic listing

    Currently Reading 0

    • No registered users viewing this page.

    Account

    Navigation

    Search

    Search

    Configure browser push notifications
    Chrome (Android)
    1. Tap the lock icon next to the address bar.
    2. Tap Permissions → Notifications.
    3. Adjust your preference.
    Chrome (Desktop)
    1. Click the padlock icon in the address bar.
    2. Select Site settings.
    3. Find Notifications and adjust your preference.