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Module 1 (Intro To Basics) > Enteral Tubing and Nutrition > Flashcards

Enteral Tubing and Nutrition Flashcards

(44 cards)

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1
Q

Tubing based on destinations
Nares to Stomach

A

Nasogastric (NG) tube
Dobhoff (NG) tube = difficult too small liquid

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2
Q

Tubing based on destinations
Nares to Small Intestine

A

Nasoduodenal tube
Nasojejunal tube

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3
Q

Surgical operation
with Tubes and Destinations

A

Gastrostomy (PEG) - stomach
Jejunostomy (J)tube - small intestines

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4
Q

PEG full name

A

Percutaneous Endoscopic Gastrostomy

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5
Q

PEG

A

-Long lasting
dysphagia
cancer/radiation affecting GI Tract
neurological deficit
bowel disease/dysfunction
cranio-facial abnormalities, trauma
malnutrition concerns

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6
Q

Tube vs. Button

A

Tube= abdomen and PEG showing catheter fixation
Button= abdomen and balloon fixation of low profile gastrostomy device

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7
Q

Once a tube has been placed, what is critical

A

confirmation

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8
Q

How do you confirm tube placement?

A

Xray is gold standard for initial confirmation

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9
Q

Always access placement by

A

measurement of tube

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10
Q

How long does it take to insert a NG tube

A

20-30 mins

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11
Q

Deviations of Tubing Length
(increases / decreases)

A

increase in length possibilities
-from intestines into stomach
-stomach into esophagus
-into lung
decrease in length possible
-stomach into intestines

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12
Q

What do you do before administering ANY meds or feedings

A

Qualified Nursing Actions
S/S of intolerance
Document findings
Follow agency policy

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13
Q

PEG value is aka

A

Lopez valve

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14
Q

Enteral Meds must be in

A

liquid or powder form via pill crusher

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15
Q

DO NOT CRUSH PO

A

EC
SR/SA/TR/CR/XL/XR
SL
Bucc

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16
Q

Preparation Rules

A

Know meds
-correct part of delivery to GI tract
Ask allergies
FINE Powder if need to crush (15-15-30)

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17
Q

How to give Enteral Meds

A

1)In med room, prepare each crushed/liquid medications in their individual label
2)Take med sleeves and pill packaging with you for verifying and scanning
3)At the bedside, mix each med individually with 15 mL sterile water
4)Confirm tube patency by gently flushing the gastric tube with 15 mL of sterile water
5)Pinch/Clamp proximal end of gastric tube each time to prevent air from entering the stomach
6)Attach syringe to the feeding tube
7)Pour dissolved meds and allow for gravity to flow through tube
8)Flush with 10 mL between each medication to prevent drug interactions
9)After administering final meds, flush with 30 mL of sterile water
10)Leave HOB elevated for 30 minutes

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18
Q

Before Proceeding Assess the pt’s GI system

Study These Flashcards
A

bowel sounds
location of enteral tube
feeding in progress and hold

19
Q

Prevent Infection

Study These Flashcards
A

initially thin gauze btw Gtube or Jtube external disk
clean site regularly
monitor skin for breakdown, drainage, yeast infection, replace bumper

20
Q

Closed system

Study These Flashcards
A

Ready Made
nutrition solution added during manufacturing
-can’t be opened
-safely hang for 24-36 hours
more common

21
Q

Open system

Study These Flashcards
A

Rehab long term
nutrition solution prepared by urse at bedside

22
Q

Both open and closed systems are administered via

Study These Flashcards
A

enternal pump

23
Q

Continuous infusions

Study These Flashcards
A

administered over 24 hours periods using enteral pump
-initial dose full strength at slow rate and increase 8-12 hours until goal reached
HOB elevated at all time 30 degrees

24
Q

Cyclic Nutrition

Study These Flashcards
A

continous in less than 24 hours
often at night
may eat during the day
flush with 30 mL of sterile water when finished
HOB at 30 degrees

25
Intermittent
feedings usually begin full strength at specified vol 5-8 times per day **Administered over at least 30 mins via pump or syringe provides needed cal and vol in 4-6 times a day Elevate HOB at least 1 hour after feeding**
26
Bolus
syringe used to deliver formula into stomach by gravity raising and lowering syringe regulated flow delivered more rapidly than intermittent HOB up at least 1 hour flush 30 mL of sterile water
27
High Risk
diarrhea nausea/vomiting gas/bloating/cramping constipation dehydration hyperglycemia aspiration
28
Biggest Risk of Enteral Nutrition
Aspiration
29
Signs and Symptoms of Aspirations
cough SOB Gurgling rapsy voice
30
What to do if suspect aspiration
stop feeding elevate bed turn on the right side notify physician check placement based on order
31
what to do for Adult tube feeding intolerance
stop feeding check constipation notify physician
32
Adult tube feeding intolerance
Abdomenal signs ( distension, firm, tense, guarding, discomfort) nausea (common) -atiemetics, minimal narcotics, check for constipation
33
Emesis
hold feedings check for constipation notify
34
Gastric Residual Checks (20 mins on right side)
critical ill surgery/trauma pt, head injury, post-op abdomenal surgery, obtunded/vegetative state
35
When do you discontinue order for GRV checks
48-72 hours or if less than 500 mL and no abdominal signs present
36
Before proceeding with a feeding
access pt's GI system (bowel sounds, location of tube) HOB at 30 degrees room temp feedings primed tubing
37
Check placement
verify by Xray aspirate to assess patency and gastric contents ig symptomatic -Exception not jejunostomy tibe or Levine/dobhoff tube measure contents and return flush with 30mL sterile water document findings
38
When do you STOP and don't proceed, if giving enteral medications or feedings?
If greater than 500 mL residual -return and flush with 30 mL recheck in 4 hours -if the same stop feeding and notify
39
Gravity feedings
HOB 30 connect device and administer via gravity flow slowly flush with 30 mL HOB up for 1 hr
40
Pump feedings
HOB 30 connect primed pump tubing ensure pump rate as ordered open clamp and start infusion monitor gastric residual every 4 hours flush per protocol
41
Metaclopramide/Reglan
gastroparesis, GERD, nausea, vomit
42
Ondansetron/Zofran
nausea and vomit
43
Nursing Interventions/Care
monitor constantly for intolerance signs I&O daily weight oral care monitor accu-checks carefully always access tubes for correct placement and proper labeling change prepared to feed every 8 hours and closed enteral feedings every 24 or when empty Never let tubing go dry aware of tubing when transferring or changing pt position
44
Skin irritation and infection prevention
thin gauze or external disk (bumper) clean site regularly monitor skin for breakdown, drainage, yeast infection, replacemtn

Module 1 (Intro To Basics) (32 decks)

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