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Fundamentals 2 Exam 4 Flashcards > Enteral Feedings Flashcards > Flashcards

Enteral Feedings Flashcards

1
Q

Enteral Nutrition is also called-

A

Total Enteral Nutrition (TEN)

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2
Q

Whenever a pt is unable to use the GI route, what could be beneficial for them?

A

TEN

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3
Q

Enteral Access is achieved by what?

A

Nasogastric tubes
Nasointestinal (nasoenteric) tubes
Gastrostomy tubes
Jejunostomy tubes

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4
Q

Inserted through nostril, advanced down through the nasopharynx, and into the alimentary tract =

A

Nasogastric Tubes

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5
Q

Are NG Tubes for short or long term therapy (Feedings)?

A

Short term therapy

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6
Q

What size catheter is used for a nasogastric tube?

A

Traditional Large-Bore (Larger than 12 Fr)

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7
Q

NG Tubes are not advised for feeding if-

A

The gag reflex is not intact

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8
Q

Why are NG Tubes not recommended if the pt’s gag reflex isn’t intact?

A

Because of the risk of accidental placement in the lungs

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9
Q

What are the purposes of an NG Tube?

A

Tube feedings and med administration

For stomach lavage following poisoning or overdose

For prevention of N/V & gastric distention postoperatively

To obtain stomach contents for diagnostic analysis

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10
Q

Inserted through a nostril and goes down into the upper small intestine =

A

Nasointestinal Tubes

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11
Q

Used when clients are at risk for aspiration. May need specialized training to insert =

A

Nasointestinal Tube

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12
Q

How long are Nasointestinal Tubes?

A

Longer than NG tubes (~ 40 cm)

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13
Q

What are Nasointestinal Tubes used for?

A

Pt’s at risk for Aspiration

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14
Q

Clients who are at risk of aspiration during a tube feeding are those with:

A

Decreased LOC
Poor cough or gag reflexes
Inability to participate in the procedure
Restlessness or agitation

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15
Q

How are Gastrostomy Tubes inserted?

A

Surgically inserted by surgeon through surgery or by laparoscopy through abdominal wall into stomach

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16
Q

What are Gastrostomy Tubes used for?

A

Long term nutritional support (More than 6-
8 weeks)

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17
Q

How are Jejunostomy Tubes inserted?

A

Surgically implanted through abdominal wall into jejunum

18
Q

What are Jejunostomy Tubes used for?

A

Long term nutritional support

19
Q

What are some things that you’d do for a NG Tube insertion?

A

Explain procedure
Position in high fowler’s position
Assess nostril patency
NEX Measurement
Lubricate tube (water soluble jelly)
Insert tube
Check placement
Secure tube
Document

20
Q

What should you lubricate a NG Tube with?

A

Water soluble jelly

21
Q

What position should you put a pt in when inserting an NG Tube?

A

High Fowler’s

22
Q

How should you care for a NG Tube on the daily?

A

Inspect nostril for discharge or irritation

Clean nostril and tube with moist cotton-tipped applicator

Apply water soluble lubricant if nostril dry or encrusted

Remove tape daily; clean & dry skin; assess skin; re-tape

Frequent oral care; mouth breather possibly due to tube presence

23
Q

Methods for checking NG Tube placement include:

A

X-ray
Aspirate gastric contents
Measure pH
Confirm tube length with insertion mark

24
Q

Which is the best indication of proper nasogastric
tube placement?

A.) pH of contents
B.) Gastric content aspiration
C.) Air auscultation
D.) X-ray

A

D

25
Q

What should you always do during NG Tube removal to prevent fluids from draining into the throat?

A

Pinch the tube

26
Q

What are some things that you should do during NG Tube removal?

A

Explain procedure

Wash hands

Sitting position if able

Pad or towel across chest

Detach tube

Have client take a deep breath and hold it

Pinch tube to prevent contents from draining into throat

Remove tube slowly and evenly over 3 – 6 seconds

Coil tube around hand while removing

Place tube into trash bag

Provide oral care & allow to blow nose following removal

Dispose of correctly

Document

27
Q

What should you always do before NG Tube irrigation?

A

Check Placement

28
Q

How often should you irrigate an NG Tube, why?

A

Irrigate every 4 hours to check placement and to maintain patency of tube

29
Q

How many mL of water should you instill when irrigating an NG Tube? How should you irrigate one?

A

Gently instill 30-50 mL of water or NS with irrigation syringe per agency policy

Pull back into syringe to check patency; repeat if tube flow sluggish

30
Q

How many mL of food are usually given during an NG Tube feeding?

A

Less than 100 mL

31
Q

Hold/delayed feedings may be warranted whenever giving how many mL of food?

A

Over 100 mL

32
Q

When doing an NG Tube feeding, what should you do?

A

Assess bowel sounds; absent (hold feeding and contact HCP)

Assess tube placement (check pH)

Check residual and return contents

Warm feedings to room temperature to prevent cramping and diarrhea

Use feeding pump for cyclic or continuous feedings

Keep HOB elevated

Check expiration date of formula

33
Q

During an NG Tube feeding, you shouldn’t leave solutions hanging for any more than how long? Why?

A

8-12 hours. Prevents microbial growth

34
Q

What are some precautions to keep in mind whenever it comes to NG Tubes?

A

Check placement before feedings & meds

Change tubing and container every 24 hours

Do not hang more than 8-12 hours worth of solution at a time in open systems (prevents bacterial growth)

Check expiration date

Check formula type

Shake formula well before pouring

Assess bowel sounds

Administer feeding per prescriptions

Flush with 30-50 mL after feeding complete

35
Q

You have a pt who is getting a feeding via a NG Tube. What should you assess about your pt?

A

Assess bowel sounds + Placement of tube + Abdominal distention + Urine for sugar and acetone + Hematocrit + Urine specific gravity + BUN + Sodium level

36
Q

What are some potential GI Complications from NG Tube Feedings?

A

Diarrhea
Vomiting
Constipation

37
Q

What are some potential non-GI Complications from NG Tube Feedings?

A

Tube displacement

Delayed gastric emptying

Fluid overload

Aspiration

Clogged tube

38
Q

How should you administer meds via an NG Tube?

A

Make sure med can be crushed or capsule opened

Crush meds and dissolve in 15-30 mL water

Check placement and residual prior to administration

Assess bowel sounds

Draw medication up into catheter tip syringe

Administer medication into tube

Flush tube with 30-50 mL water or NS

Clamp tube for 30-60 minutes depending on agency policy

39
Q

Low continuous suction or high intermittent may be used with this kind’ve tube =

A

Salem Sump

40
Q

Low intermittent suction is recommended with this kind’ve tube =

A

Levin Tube

41
Q

Why is it important to have a client take a deep breath and hold it during NG tube removal?

A.) To prevent client from gagging
B.) Prevents accidental aspiration of contents
C.) Prevents contents from draining in throat
D.) Prevents transmission of microorganisms

A

B

42
Q

Nurses should assess placement of any gastrointestinal tube before performing which actions?
Select all that apply:

A.) Instilling feedings
B.) Administering medications
C.) Irrigation of tube
D.) Lung auscultation
E.) Assessing bowel sounds

A

A, B, C

Fundamentals 2 Exam 4 Flashcards (12 decks)

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