Term
What are the purposes of N/G tubes? 5 things. |
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Definition
- Gastric Decompression (applying pressure internally w/balloon) for intestinal obstruction or ileus.
- Gavage (instillation of liquid nutrition) or Lavage (taking out stomach contents)
- Removal of gastric secretions post GI surgery to allow wound healing.
- To Obtain gastric content samples for analysis
- Lavage stomach to remove ingested substance.
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Term
| What is the NEX measurement? |
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Definition
| Naso to Ear to Xyphoid process measured prior to tube being inserted. |
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Term
| What is the feeding tube? |
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Definition
| Used to provide nutrition. NG (nasogastric), PEG (percutaneous endoscopic gastrostomy), or Dobhoff (small-bore nasogastric tube), J-Tube (jejunostomy), or Gastrojunostomy used. |
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Term
| When is a feeding tube inserted? |
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Definition
Inadequate Oral Intake NPO > 5 days. ex. dysphagia |
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Term
| What must the individual have for a feeding tube? |
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Definition
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Term
| What must you do prior to starting a tube feeding to a newly inserted feeding tube? |
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Definition
| Verify placement. XRay is most accurate. |
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Term
| What are the complications of feeding tubes? |
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Definition
Aspiration GI Complications Mechanical Complications Metabolic complications |
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Term
| What must you do to prevent aspiration? |
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Definition
| Raise head of bed to 30-45 degrees. Stop continuous feeding when lowering patient to turn, then resume. |
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Term
| Is Diarrhea normal with feeding tubes? |
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Definition
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Term
| If cramping occurs during tube feeding, what's one quick thing you can do to help stop it? |
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Definition
| Lower the bag to slow infusion rate. |
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Term
| What type of feedings can cause cramping. |
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Definition
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Term
| What are the various types of enteral feedings? |
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Definition
- Continuous (ex. Kangaroo pump)
- Intermittent (overnight), ex wound healing
- Bolus - Feeding placed in bag. Given by gravity or syringe.
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Term
| How much tube feeding should be placed in an open system? |
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Definition
| No more than 8 hours worth. |
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Term
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Definition
| Gastric contents removed via feeding tube. Do not return if decompression is being used. If residual filled tube, remove, place in container then do it again. When complete, return all liquid to Pt. unless on decompression. |
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Term
| What is the purpose of residuals? |
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Definition
| Helps ID the rate food is being digested. If excessive, stop feeding and consult Dr. |
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Term
| What would indicate a patient has aspirated tube feeding? |
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Definition
| Wet lung sounds, cyanotic, coughing. |
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Term
| What should you do if you suspect that the patient has aspirated tube feeding? |
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Definition
- Stop feeding
- Place pt in side-lying position
- Suction (may need order)
- Elevate head of bed
- Notify physician
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Term
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Definition
- Used for long term enteral feeding.
- Surgically placed directly through wall of stomach or jejunum.
- Tube is not visible under clothes
- Esophageal irritation is avoided.
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Term
| Why and when is a PEG used? |
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Definition
| For those who can't chew or swallow food. Helps improve quality of life, maintain weight and nutrtion levels. |
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Term
| What is a Salem Sump tube? |
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Definition
| An NG tube used for suction. |
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Term
| What is its (Salem Sump tube) claim to fame? |
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Definition
| Suction w/no air can ruin the lining of the stomach by creating a vacuum seal. Extra tube is provided to prevent ulcers. One way valve prevents leaking. |
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Term
| Why do you irrigate N/G tubes? |
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Definition
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Term
| How often do you irrigate a N/G tube to suction? |
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Definition
As ordered by the physician, indicated
by facility policy or when the tube is occluded. |
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Term
| What do you irrigate with? |
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Definition
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Term
| Under what circumstances do you not irrigate an N/G tube? |
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Definition
Fresh post-op or without an
order/policy |
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Term
| What types of suction do you have for nasogastric suction? |
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Definition
- Intermittent (Low -LIS = less pressure and High - HIS = greater pressure)
- Continuous
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Term
| When you are removing a N/G tube to suction, what should you assess? |
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Definition
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Term
| What should the nurse do if difficulty is encountered placing an NG tube due to gagging of the client? |
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Definition
| Pull back till coughing subsides and look in oropharynx to see if tube is coiled. Allow client opportunity to take several breaths and relax. Then, have client tuck chin, suck water through straw and swallow when nurse advances the tube. |
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Term
| The nurse is having difficulty administering medications through dobhoff tube. Should the nurse use a large piston syringe with the plunger inserted to assist in propelling the meds? If not, what are the other options? |
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Definition
| Larger syringes such as a 50cc will produce less force as well as less possibility of rupturing end of dobhoff tube due to excessive pressure. Be sure medications are completely cruched and dissolved. If this is difficult, consult the pharmacy for a liquid form of the medication. |
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Term
| When the client is on continuous tube feeding at 50 mls/hour and the nurse obtains a residual of 100 mls or greater, what should the nurse do? |
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Definition
| Return up to 100cc of residual (to avoid upsetting patient's electrolyte balance) and follow institutional policy which may recommend holding the TF for a specified amount of time or notifying the physician. Ensure the head of bed is elevated at least 30 degrees. |
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Term
| What should the nurse do if upon entering the room, the large bore NG tube appears to have slid most of the way out of the client's nose and the tape that was on the nose is now 6 inches from the nose, still attached to the NG tube? |
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Definition
| Look in orophaynx for current location. If tip is not visible aspirate any fluid that is in tubing and discard, then follow standard procedure for reinsertion and verification of placement. If this had been a Dobhoff tube, it should be completely removed and reinserted using stylet per protocol. |
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Term
| Is there anything the nurse should do prior to removing an NG tube? Why? |
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Definition
| Instill 50cc of air into the tube to decrease risk of aspiration of fluids during removal. |
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Term
| What should the nurse do if the aide has just poured 2 cans fo tube feeding into your clients continuous feeding bag and the bag's tag says it was hung 32 hours ago? |
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Definition
| Discard all feeding and old bag and hang new bag and tubing and refill again. Be sure to label new tubing with date and time it was hung. |
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Term
| You are assessing your patient at the beginning of the shift and note that the site around your client's PEG tube is red with crusty drainage. What should be done? |
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Definition
| Wash gently with soap and water and use Q-Tip as needed to clean areas immediate to PEG tube. Check institutional policy for application of antibacterial ointment. Most institutions discourage the use of "drain sponges" as they can place too much tension on the PEG tube, causing it to pull out of the stomach. |
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