Normal saline is not an appropriate substitute for internal feeding solution. Secondly, hydration was not being achieved by the normal saline boluses through the gastric tube. The colon was unable to re-absorb the fluid, and as a result this client's fluid and electrolyte balance was being undermined. Immediately, the M.D. should have been notified and pressured for at least an electrolyte work-up to determine if the M.D. had been achieving his goal of hydrating the client. And finally, no matter how demented a client may be they alone are able to tell the caregiver about the nature of their discomfort - listen to them.
Acute pain is always a foreboding sign.
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