Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

7th Semester > 400 EXAM 2 > Flashcards

400 EXAM 2 Flashcards

1
Q

ϖ Insertion of a flexible tube into the stomach, beyond the pylorus into the duodenum (first part of small intestine) or the jejunum (second part)

A

GI intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ϖ Reasons for GI Intubation

A

decompress the stomach

lavage

diagnose disorders

administer meds and feedings

compress a bleeding site

aspirate gastric contents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

o mouth to stomach

A

orogastric tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

o Large-bore tube inserted through the mouth with a wide outlet for removal of gastric contents

A

orogastric tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

do nurses put in the orogastric tubes?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

nose to stomach

A

nasogastric tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

NG tubes are used for?

A

decompression
admin meds
give feedings
fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how long have NG tubes be in before you change it?

A

4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

NG tubes are not for long-term but more for ______.

A

suction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

2 types of gastric tubes?

A

Levin & Salem (gastric) pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the levin tube is connected to ____ _____ _____ (30-40mm Hg) to avoid erosion or tearing of the stomach lining.

A

low intermittent suction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

the gastric (salem) sump is a ____-lumen

A

double

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

inner lumen of salem pump

A

vents the larger suction-drainage tube to the atomosphere

to prevent compression & injury to stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

where must the salem pump stay?

A

above patient’s waste

(to prevent reflux of gastric contents through it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

used for providing nutrients, fluids, medication

soft and playable.

A

• Nasoenteric tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

• Nasoenteric tubes are inserted by who?

A

surgeon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

goes into stomach and then in 24 hours will be in small intestine via peristalsis

A

• Nasoenteric tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

add how many inches for intestinal or stomach placement of tube?

A

stomach: 4-6 inches
intestinal: 8-10 inches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

should be used to confirm tube placement in stomach (Feedings)

A

• X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

• Each time liquids or medications are administered and each shift for continuous feedings, tube must be checked for?

A

correct placement:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

other ways to check placement?

A

measure tube length

aspiration color

pH measurement of aspirate

air auscultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

gastric aspirate pH

A

1-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

intestinal aspirate pH

A

6 or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

respiratory aspirate pH

A

7 or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is usually clogging the tubes?

A

medications, or feedings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how to clear aspirate?

A

use 30-60ml syringe to aspirate contents and

if that doesn’t work leave warm water in the tube for 5-15 minutes

if that doesn’t work air insufflation (20 ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

− Enzymes to clear tube may also be used to unclog NG tubes

A

digestive enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how often to change the tape with NG tubes?

A

every 2-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

• Displacement of tube can occur by

A

positioning, moving, pulling, coughing, suctioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

• Do not replace tube if patient is post ____ or _____ surgery.

A

esophageal or gastric surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

replacing the tube is a risk for interrupting ______.

A

anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

when to irrigate the tube?

A

o 4-6 hours with continuous feedings

o 2 times daily without continuous feedings (20ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

possible complications with tubes

A

fluid volume deficit

dehydration

respiratory complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

sx of dehydration

A

♣ Dry mouth, dry skin, decreased urine output, poor skin turgor, orthostatic hypotension, decreased blood pressure, lethargy, light-headedness, increased heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

♣ Coughing/clearing throat is impaired, increase risk of ______.

A

aspiration

also tachypnea and fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

directly after tube feedings?

A

sit the patient up for 1 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

medicines to prevent aspiration?

A

prokinetic agents (erythromycin and reglan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how to pro kinetic agents work?

A

soften LES. help stomach empty fluids to prevent aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what to do prior to removing the tube?

A

flush with 10 ml NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

o Given to meet nutritional requirements when oral intake is inadequate of not possible

A

enteral feedings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

the GI tract is still functional with ____ feedings

A

enteral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

advantages of enteral feedings

A

cheaper, safer, well tolerated by patients, easier to use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

conditions that may require enteral therapy

A 
Hypermetabolism
Neurological disease
Cancer 
Psychiatric disease
Organ system failure
Learning disability
Failure to thrive
Facial/oral problems
Gastrointestinal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

• Normal osmolality of body fluids is approximately ____ mOsm/kg

A

300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

high osmolality feedings can cause ________ _____.

A

dumping syndrom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

sx of dumping syndrome

A

fullness
nausea
diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

dumping syndrome leads to ?

A

dehydration

hypotension

tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

preventing dumping syndrome

A

slow down feedings formula rate

give feedings at room temp

admin feedings by drip and not bolus

stay in semi fowlers for 1 hr after feedings

instill minimum Amt of water when flushing.

49
Q

− Administering feedings over 30 minutes at designated intervals by a reservoir enteral bag and tubing

A

• Intermittent gravity drip

50
Q

− Lower risk for aspiration and complications

− Delivery of feedings incrementally by slow drip over long periods

A

• Continuous feeding

51
Q

• Continuous feedings by a slow drip may reduce ?

A 
aspiration
nausea
distention
vomiting
diarrhea
52
Q

− Infused feeding is given over 8-18 hours

− Feedings can infuse at night to avoid interrupting the patient’s lifestyle

A

• Cyclic feeding

53
Q

− May be appropriate for those being weaned from tube feedings to an oral diet, or those who cannot eat enough and need supplements, or those at home who need daytime hours free from the pump

A

• Cyclic feeding

54
Q

when to check gastric residual?

A

o for intermittent before each feeding/med

o continuous feedings Q4H (return residual)

55
Q

you can crush a ____ not a _____.

A

capsule; tablet

56
Q

• At least 30-50mL of water or NS flush is administered when:

A

− Before and after each dose of medication and tube feeding

− After checking for gastric residuals and gastric pH

− Every 4-6 hours with continuous feedings

57
Q

liquid meds via NG tube

A

no preg

58
Q

simple compressed tablets via NG tube

A

crush and dissolve in water

59
Q

buccal or sublingual tablets via NG tube

A

administer as prescribed

60
Q

soft gelatin capsules filled with liquids via NG tube

A

puncture and squeeze out

61
Q

what types of meds you can not crush for NG tube?

A

enteric coated

time released tablets

time released capsules

62
Q

how often to change feeding tubing and bag?

A

q24 hours.

63
Q

• NG or nasoenteric tube feeding can cause ?

A

diarrhea or constipation

64
Q

o Causes of diarrhea

A

malnutrition

medications

C.dif from ATB use

Zinc deficiency

concomitant lactose intolerance

dumping syndrome

65
Q

• Water flushes given Q4H and after feedings to prevent ?

A

hypertonic dehydration

66
Q

o Feeding tube directly into the stomach

A

gastrostomy

67
Q

ex of gastrostomy

A

PEG TUBE

68
Q

o gastrostomy tubes can Also be used for gastric decompression when what occurs?

A

intestinal obstruction

69
Q

o Preferred route if enteral nutrition is needed for longer than 4 weeks

A

gastrostomy

70
Q

gastrostomy tubes are first choice for patients in a ____.

A

coma

71
Q

• Initial tube can be removed and replaced once the tract is well established, typically 6 weeks to 3 months

A

PEG tube

72
Q

o LPGD

A

• Low profile gastric device

73
Q

have one way valve (so can’t check residual)

inserted flush with the skin

A

LPGD

74
Q

− Formula feeding can begin ___-____ hours post tube insertion

− Infusion rate gradually increased

A

2-24

75
Q

− If tube placed for gastric drainage?

A

connect to low intermittent suction of gravity drainage bag (measure and record drainage)

76
Q

o Normal to see ___ ___ drainage for a couple days

A

scant serous

77
Q

the nurse needs to remember to ___ the tube daily

A

turn

78
Q

– no turning of the tube can cause pain

A

o Buried bumper syndrome

79
Q

Skin may become irritated from _______ action of leaking gastric juices

A

enzymatic

80
Q

if skin is wet around stoma?

A

pat dry

81
Q

− Skin at exit site is evaluated daily for signs of

A

breakdown, irritation, excoriation, presence of drainage or gastric leakage, bleeding

82
Q

− Dislodgement requires immediate attention because tract can close within ___-___ hours if the tube is not replaced promptly

A

4 to 6

83
Q

what to do if dislodgment occurs?

A

insert foley

84
Q

tube feeding complications?

A

tube obstruction

vomiting/aspiration

diarrhea

constipation

dehydration

85
Q

how to prevent tube obstruction?

A

crush all meds and flush with warm tap water

86
Q

how to prevent diarrhea?

A

slow feedings

87
Q

how to prevent constipation?

A

change formula or increase flushes

88
Q

TPN is used when?

A

GI is not functional

89
Q

Method of providing nutrients to the body by an IV route

A

TPN

90
Q

ϖ If digestive system isn’t working or needs to rest you would use what type of nutrition?

A

TPN

91
Q

goals for TPN

A

ϖ to improve nutritional status, establish a positive nitrogen balance, maintain muscle mass, promote weight maintenance or gain, and enhance the healing process

92
Q

how long can you use TPN

A

7-10 days

b/c high glucose, protein, and fat

93
Q

clinical indications for parenteral nutrition

A

insufficient intake

impaired ability to ingest food

unwilling or unable to digest nutritients

prolonged preop and postop nutritional needs

major body burns

inability to ingest adequate oral or fluids within 7 days

malnourished

94
Q

o need about _____-_____ calories a day

A

1200-1500

95
Q

amt of formula administered over a 24 hour period

A

1-3 L

96
Q

o Simply looks like milk hanging in a bag

o Has to be ordered by physician - individualized

A

formula

97
Q

o Inspect bag—> do not use if:

A
  • Separation and oily appearance – cracked solution

* Precipitate – white crystal

98
Q

what to do if formula is cold?

A

let it sit out for 30-45 minutes

99
Q

single or double lumen

bacillic or cephalic vein

A

PIC

100
Q

jugular vein or subclavian

inserted by surgeon or ACNP

A

central line

101
Q

needs a fllter

A

TPN

102
Q

does not need a filter

A

INTRAVENOUS FAT EMULSIONS (IVFEs)

103
Q

• Usually length of therapy is 5-7 days

A

o Peripheral Method PPN

104
Q

TPN is delivered through?

A

central line

105
Q

PPN is delivered through?

A

PIC line

106
Q

the middle lumen is used for?

A

food

107
Q

parenteral Solution discontinued _____ to allow patient to adjust to glucose levels

A

gradually

108
Q

if parenteral solution is stopped abruptly, what do you need to do?

A

o isotonic dextrose can be administered at same rate for 1-2 hrs

109
Q

♣ The most common complication of central line

A

pneumothroax

110
Q

site care for central line

A

monitor for infection

change dressing every 7 days

high risk for bacterial growth

111
Q

the more you change the dressing—–

A

the higher risk for infection

112
Q

sx of infection with central line

A

Redness, drainage, erythema

113
Q

sx of sepsis with central line

A

− fever, chills, N/V, septic shock, even death

114
Q

how to prevent air embolism

A

make sure cap is tight

115
Q

what if you walk into room and cap is off ?

A

valsalva maneuver

116
Q

• Sometimes given with TPN

Patients who need large amount of calories quickly and you’re worried about fluid overload

A

fat emulsions

117
Q

• patients can have allergic reactions to fat emulsions. what is sx?

A

for dyspnea, fever, cyanosis, flushing, phlebitis

118
Q

• If solution runs out ?

A

10% dextrose and water infused at same rate

7th Semester (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions