JerseyCCRN

How much water does a patient need per day to meet hydration requirements if they are strictly fed via G-tube? I have a patient who receives 4 20 ounce water bottles per day, 4 cans of Jevity 1.2 cal (237 ml) 8 oz can. I want to make sure this is meeting his nutritional needs. Background, patient is 75 y/o man, no history of kidney/liver issues. G-tube due to aspiration and swallow issues. Patient is a quad, wife cares for G-tube. She stated she sometimes gives soda pop via tube in place of water. No fluids/foods by mouth, strictly G-tube nutrition. I researched this to no avail, dietician with my agency are not available until next Tuesday. PCP not giving me the time of day. I want to make sure this patient is receiving what they need. This regimen is ordered by MD. Currently tube has brown residue that looks like mold, PCP saw patient Friday and said it was a non-issue. This very well meet all requirements, I am just not too familiar with G-tube protocol. Thanks! PS not asking you to give me advice to treat this patient. I will likely not see this patient again, as I do not typically work weekends, I was just filling in for a call out.

Very sound advice my friends, I will update tomorrow how things go.

No I'm actually the first nurse to see this patient. The problem is that most of the other nurses are newer so they "don't like to send them to difficult cases". Which is a bunch of bologna. I need a paycheck to pay the rent, long story short my options for acute care are limited due to an injury. I have loved the laid back pace of home health and have had nothing but positive experiences aside from this. I just wish management would be more involved and listen when their more experienced nurses encounter a problem. I am going to refuse, I guess if I am terminated for this then it is meant to be. Something about this man just seemed off and he genuinely frightened me. They will probably make a fuss but I am hoping they don't terminate me. Setting boundaries is just a weakness of mine, guess I better buck up. Thanks for your reply :)

I have been dabbling in home health for a while now and have been having trouble setting boundaries. Recently I had a patient who was verbally aggressive towards a me. I have dealt with my fair share of angry patients but this one is still bothering me. The aggression was not a result of his disease process, he was a younger man, around 55 and was cognitively intact. He is a new patient of mine and I had several initial questions for him and he kept screaming at me telling me how much of an idiot I am for asking such stupid questions. He also made a comment that I better watch my back in his neighborhood because people in scrubs get "robbed and stuck" because they are likely caring meds or valuables (cell phone ect.) I told my manager that I was not willing to return to this case and explained the situation. They said to suck it up. I have been a nurse for many years and have fairly thick skin, but being verbally harassed for an hour just took a toll on my mentally and physically. I was shaking walking to my car and was really scared (silly I know) How would you handle this situation. I'm having anxiety already dreading the follow up and I'm thinking about outright refusing the case, but I fear they will terminate me. Times like this I yearn for the hospital environment where I could quickly call security. Home health sure isn't the semi-retirement laid back atmosphere I thought it would be