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Jay Cardio Jay Cardio
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6 years ago
A newborn with esophageal atresia has just returned from surgery to place a gastrostomy tube. Which nursing diagnosis will the nurse use to plan the care for this patient?
 
  A) Risk for imbalanced nutrition
  B) Risk for deficient fluid volume
  C) Risk for impaired skin integrity
  D) Risk for ineffective gas exchange
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6 years ago
C
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: The patient is at risk for impaired skin integrity related to gastrostomy tube insertion site. Acidic gastric secretions can leak onto the skin from the gastrostomy site, leading to skin irritation. The nurse should plan interventions to protect the skin by using a cream or commercial skin protection system or consult with a wound, ostomy, and continence therapy nurse to reduce the possibility of skin irritation and infection. With the placement of the gastrostomy tube, the patient is at less risk for imbalanced nutrition and deficient fluid volume. The gastrostomy tube will not affect the patient's gas exchange.
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