Nasogastric Feeding Flashcards
(149 cards)
1
Q
What is the first step in the checklist for evaluating competency in enteral tube feeding?
A
Document the relevant information (assessment findings, pharmacological and nonpharmacological interventions) in the client’s medical record.
2
Q
What should be provided to the client before starting the procedure?
A
Privacy
3
Q
What is an important hygiene practice before interacting with the client?
A
Perform hand hygiene and put on appropriate PPE if indicated.
4
Q
What should be verified regarding the client before tube insertion?
A
Client identification
5
Q
What is necessary to determine regarding the client’s health history?
A
Whether the client has allergies.
6
Q
What should be verified from the provider before inserting the tube?
A
Provider’s prescription for tube insertion.
7
Q
What is the purpose of measuring the tubing during the procedure?
A
To ensure correct length for insertion.
8
Q
How should the tubing be measured for insertion?
A
Place tip of tubing near client’s nose, extend to earlobe, measure down to the xiphoid process, and then add 8 to 10 inches.
9
Q
What should be done to reassure the client during the procedure?
A
Provide reassurance to client.
10
Q
What might occur when reaching the pharynx during tube insertion?
A
Gagging may occur.
11
Q
What technique can help the client during tube advancement?
A
Encourage client to sip through a straw (if client is not NPO).
12
Q
What should be monitored for during tube advancement?
A
Excessive gagging or coughing for misplacement.
13
Q
What is the next step after confirming tube placement?
A
Remove guidewire and secure tube per agency policy.
14
Q
What should be performed after the procedure is completed?
A
Perform oral hygiene.
15
Q
What must be ensured before leaving the client’s room?
A
Client is in a safe position and has the call light within reach.
16
Q
What should be documented in the client’s medical record during enteral tube feeding?
A
Amount of insulin, injection site, and client assessment
Accurate documentation is crucial for tracking the client’s care and treatment.
17
Q
What is the first step to take when preparing for enteral tube feeding?
A
Provide privacy as needed
Ensuring privacy helps in maintaining client comfort and dignity.
18
Q
What is the importance of verifying client identification?
A
To ensure the correct client is receiving treatment
This step is critical to avoid medication errors.
19
Q
What should you determine about the client before administering enteral nutrition?
A
Whether the client has allergies
Knowing allergies helps prevent adverse reactions.
20
Q
What is the recommended head elevation for a client during enteral feeding?
A
30 to 45 degrees
This position helps reduce the risk of aspiration.
21
Q
What are the two methods to confirm tube placement?
A
Using two methods
Confirmation methods can include auscultation and pH testing.
22
Q
How much water should be used to flush the feeding tube?
A
30 to 50 mL of water
Flushing helps clear the tube and maintain patency.
23
Q
What should be done to the top of the formula can before opening?
A
Disinfect the top
This step is necessary to reduce the risk of contamination.
24
Q
What is the first action when administering via syringe?
A
Remove plunger from syringe
This allows for gravity drainage of the formula.
25
What should be done before inserting the syringe into the port?
Pinch the feeding tube
## Footnote
Pinching prevents backflow during administration.
26
What should be done after administering the prescribed amount of formula?
Flush tube with amount of water as per policy
## Footnote
This ensures that all formula is delivered and the tube is clear.
27
What is the final step after administering enteral nutrition?
Have client remain on the right side slightly upright or in Fowler’s position for 30 min
## Footnote
This helps in digestion and minimizes the risk of aspiration.
28
What should be done with the gloves after the procedure?
Remove gloves and perform hand hygiene
## Footnote
Proper hand hygiene is essential to prevent infection.
29
What should be ensured regarding the client's call light?
That the call light is within reach
## Footnote
This allows the client to request assistance if needed.
30
Fill in the blank: The feeding bag should be filled with the prescribed amount of _______.
[formula]
## Footnote
Ensures the client receives the correct nutritional amount.
31
True or False: The feeding should be administered at the prescribed rate via a feeding pump or by adjusting the regulating clamp on the bag.
True
## Footnote
Correct administration rate is crucial for client safety and efficacy of feeding.
32
What should be documented in the client’s medical record?
Assessment findings, pharmacological and nonpharmacological interventions
## Footnote
Documentation is essential for continuity of care and legal compliance.
33
What is the first step in the checklist for nasogastric intubation?
Provide privacy as needed
## Footnote
Ensuring client privacy is crucial for comfort and trust.
34
What should be done before starting the procedure?
Introduce yourself to the client
## Footnote
Establishing rapport is important for patient cooperation.
35
What hygiene practice must be performed before the procedure?
Perform hand hygiene
## Footnote
Hand hygiene reduces the risk of infection.
36
What is necessary to verify before proceeding with nasogastric intubation?
Client identification
## Footnote
Verification ensures the correct patient receives care.
37
What should be determined regarding the client before the procedure?
Whether the client has allergies
## Footnote
Knowing allergies prevents adverse reactions.
38
What should be developed for the client during the procedure?
Signals for client to communicate
## Footnote
Effective communication is vital for patient safety.
39
What position should the client be assisted into?
High-Fowler’s position or at a 45-degree angle
## Footnote
This position facilitates easier tube insertion.
40
What should be placed over the client’s chest during the procedure?
A towel
## Footnote
This helps to keep the area clean and dry.
41
What is the next step after measuring the length of tubing required?
Mark it with an indelible marker
## Footnote
Marking ensures accurate tube placement.
42
What should be done if using a stylet?
Ensure it is secure and inject 10 mL of water into the tube
## Footnote
This prepares the tube for insertion.
43
What should be prepared before inserting the nasogastric tube?
Tape or fixation device
## Footnote
These are necessary for securing the tube post-insertion.
44
What should be applied to the tip of the tube before insertion?
Lubrication and anesthetics if policy indicates
## Footnote
This facilitates easier insertion and reduces discomfort.
45
What should the client be given to assist during the tube insertion?
A cup of water with a straw
## Footnote
Sipping water helps in advancing the tube.
46
What position should the client’s neck be in during the procedure?
Neutral position or flexed back on a pillow
## Footnote
Proper neck positioning aids in tube passage.
47
What technique should be used when inserting the tube through the nasal passage?
Rotate the tube to help pass through the nasopharynx
## Footnote
Rotation can ease the passage of the tube.
48
What should be done if the client experiences gagging?
Provide reassurance to the client
## Footnote
Reassurance helps to alleviate anxiety during the procedure.
49
What should be done if the tube becomes coiled in the pharynx?
Ensure the tube is not coiled
## Footnote
Coiling can obstruct the airway.
50
What position should the client be encouraged to take to facilitate tube advancement?
Flex their chin to their chest
## Footnote
This position helps in navigating the tube down the esophagus.
51
What should be done if the client becomes cyanotic or unable to speak?
Stop the procedure
## Footnote
These are signs of potential airway obstruction.
52
What is the next step after inserting the tube to the measured mark?
Secure tubing temporarily with tape
## Footnote
Temporary securing prevents displacement.
53
How can tube placement be determined?
By checking aspirate pH or bilirubin or using a CO2 detector
## Footnote
Accurate placement confirmation is crucial for safety.
54
What should be marked at the client’s nostril?
The tube
## Footnote
This helps to monitor tube placement.
55
What should be applied to the nose to secure the tube?
Skin barrier
## Footnote
A skin barrier protects the skin from irritation.
56
What should be done if a double-lumen tube is used?
Ensure vent is above stomach level
## Footnote
This is important for proper function of the tube.
57
What should be performed after removing gloves?
Perform hand hygiene
## Footnote
This is essential for infection control.
58
What should be arranged to confirm tube placement?
An x-ray
## Footnote
An x-ray is the gold standard for confirming placement.
59
What should be provided to the client after the procedure?
Oral hygiene
## Footnote
Oral hygiene is important for client comfort and care.
60
What should be documented in the client’s medical record?
Assessment findings, pharmacological and nonpharmacological interventions.
## Footnote
Documenting relevant information is crucial for continuity of care and legal compliance.
61
What is the first step in the nasogastric decompression process?
Verify the medical prescription for gastric decompression.
## Footnote
Ensuring the prescription is correct is essential for patient safety.
62
What should be done to ensure client comfort during the procedure?
Provide privacy as needed.
## Footnote
Maintaining privacy helps to build trust and reduce anxiety.
63
What is the importance of introducing yourself to the client?
It establishes rapport and ensures the client knows who is providing care.
## Footnote
Introduction is a key component of effective communication.
64
What hygiene practice must be performed before the procedure?
Perform hand hygiene and put on appropriate PPE if indicated.
## Footnote
Hand hygiene is critical to prevent infection.
65
What must be verified regarding the client before starting the procedure?
Client identification.
## Footnote
Correct identification prevents medical errors.
66
What should be determined about the client prior to the procedure?
Determine whether the client has allergies.
## Footnote
Knowledge of allergies is vital for safe medication administration.
67
What type of education should be provided to the client?
Client education.
## Footnote
Educating clients helps them understand the procedure and its purpose.
68
What must be checked to confirm placement of the nasogastric tube?
Radiography report.
## Footnote
Confirming placement is essential to prevent complications.
69
What equipment needs to be assembled for nasogastric decompression?
Drainage suction equipment.
## Footnote
Proper equipment setup is necessary for effective decompression.
70
What type of gloves should be put on during the procedure?
Clean gloves.
## Footnote
Wearing clean gloves is important for infection control.
71
How should the suction regulator be adjusted?
Per provider’s prescription by occluding the connecting tubing to the suction device.
## Footnote
Correct adjustment ensures safe and effective suction levels.
72
What should be done after confirming the placement of the nasogastric tube?
Connect nasogastric tube to the suction tubing.
## Footnote
This step is critical for the nasogastric decompression to begin.
73
What should be documented in the client’s medical record?
Assessment findings, pharmacological and nonpharmacological interventions
## Footnote
This includes all relevant information regarding the client's condition and actions taken.
74
What is the first step in the process of removing a nasogastric tube?
Verify the medical prescription for removal of the nasogastric tube
75
What should be provided to the client to ensure comfort and privacy?
Provide privacy as needed
76
What is the importance of introducing yourself to the client?
To establish rapport and trust
77
What is the recommended practice before handling a client?
Perform hand hygiene and put on appropriate PPE if indicated
78
What is the purpose of verifying client identification?
To ensure the correct client is receiving care
79
What should be determined regarding the client before proceeding?
Determine whether the client has allergies
80
What should be provided to the client as part of education?
Provide client education
81
What position should the bed be in when preparing to remove the tube?
Raise the height of the bed
82
At what angle should the head of the bed be raised?
30 to 45 degrees
83
What is placed across the client’s chest during the procedure?
Towel or disposable pad
84
What items should be offered to the client prior to the procedure?
Tissues and emesis basin
85
What should be worn before handling the nasogastric tube?
Clean gloves
86
What should be ensured regarding the wall suction tube?
Ensure any wall suction tube is disconnected from the nasogastric tube
87
What should be detached from the gown?
The nasogastric tube
88
What should be removed from the top of the nose?
The tape or holder
89
What is the amount of water or solution to flush the tube?
10 mL of water or 0.9% sodium chloride irrigation solution
90
What should be instilled through the tube as an alternative to flushing?
30 to 50 mL of air
91
What technique is used to prepare for tube removal?
Clamp or kink the tube between index finger and thumb
92
What should the client be asked to do before the tube is removed?
Take a deep breath and hold the breath
93
How should the tube be removed?
Smoothly and steadily pull the tube to remove with dominant hand
94
What should be done with the tube after removal?
Collect the tube in a towel or disposable pad with the nondominant hand
95
What should be checked for after tube removal?
Check the tip for intactness
96
What should be measured and recorded after tube removal?
The amount of output in the container by the markings on the container
97
How should the tube and suction equipment be disposed of?
Per facility policy
98
What should be done after removing gloves?
Clean nares and provide oral hygiene
99
What should be ensured for the client before leaving the room?
Client is in a safe position and has the call light within reach
100
What is a nasogastric (NG) tube?
A type of nasoenteric tube inserted through a nostril into the stomach for short-term liquid feeding or withdrawing gastric contents.
101
What is total enteral nutrition (TEN)?
Nutrition administered via tube feeding through a nasoenteric or enterostomal tube when adequate oral nutrition cannot be achieved.
102
What size feeding tube is recommended for nasogastric feeding?
A soft, flexible, small-bore feeding tube, smaller than 12 Fr.
103
What is a key responsibility of nurses regarding NG tubes?
Care and maintenance of the feeding tube and the enteral feeding.
104
How can tube occlusion be prevented?
Recognize that tube occlusion is more easily prevented than corrected.
105
How often should the NG tube be flushed to maintain patency?
At least every 4 hours, before and after medication administration, and after any interruption of enteral nutrition.
106
What should be used to unclog a NG tube?
30 mL of warm water with gentle pressure from a 50-mL piston syringe.
107
What method is most accurate for confirming NG tube placement?
X-ray.
108
When should gastric residual volumes be checked?
Before each intermittent feeding or drug administration, or at least every 6 hours during continuous feeding.
109
What should be done if the NG tube is suspected to be dislodged?
Immediately remove the tube.
110
What is the preferred system for administering continuous or cyclic feeding?
A closed system.
111
How often should the feeding bag and tubing be changed?
Every 24 to 48 hours.
112
What position should patients be in during tube feeding to prevent aspiration?
Head of the bed elevated at least 30 degrees.
113
What is the most reliable indicator of fluid gain or loss in patients receiving enteral nutrition?
Weight.
114
What complications should be monitored for during tube feeding?
Diarrhea, abdominal distention, nausea/vomiting, fluid and electrolyte imbalances, signs of aspiration pneumonia.
115
What are signs of refeeding syndrome?
Heart failure, peripheral edema, rhabdomyolysis, seizures, hypophosphatemia, and hypokalemia.
116
What should be done if a patient shows signs of aspiration pneumonia?
Observe for fever, dehydration, diminishing breath sounds, shortness of breath, and chest discomfort.
117
What should be consulted regarding medication administration via tube?
Consult with the pharmacist for compatibility with the enteral nutrition formula.
118
What is recommended regarding the use of liquid medications?
Use liquid medications instead of crushed tablets when possible.
119
What should be done before and after medication administration via tube?
Flush the tube with 30 mL of water.
120
Why is frequent oral hygiene important for patients with an NG tube?
The NG tube is irritating.
121
What should be checked regarding patient preferences for nutrition?
Advance directives regarding artificial nutrition and hydration.
122
What is a nasogastric (NG) tube?
A type of nasoenteric tube inserted through a nostril into the stomach, used for short-term liquid feeding or withdrawing gastric contents.
123
What is total enteral nutrition (TEN)?
Nutrition administered via tube feeding through a nasoenteric or enterostomal tube when a patient cannot achieve adequate nutrition orally.
124
What type of feeding tube is recommended for nasogastric feeding?
A soft, flexible, small-bore feeding tube, smaller than 12 Fr.
125
What is the nurse's responsibility regarding tube patency?
Maintain the patency of the NG tube, flush with 30 mL of water regularly, and use warm water for unclogging.
126
How often should the NG tube be flushed to prevent occlusion?
At least every 4 hours, before and after medication administration, and after any interruption of enteral nutrition.
127
What is the most accurate method for confirming NG tube placement?
X-ray is the most accurate method for initial confirmation of placement.
128
What should be done if a tube is suspected to be dislodged?
Immediately remove the tube to prevent aspiration.
129
What should be monitored during feeding administration?
Ensure proper mechanical operation of the feeding pump and monitor for proper infusion rates.
130
How often should feeding bags and tubing be changed?
Every 24 to 48 hours.
131
What position should the patient be in during tube feeding to prevent aspiration?
Keep the head of the bed elevated at least 30 degrees.
132
What are signs of fluid overload to monitor for during tube feeding?
Peripheral edema, sudden weight gain, crackles, dyspnea, increased blood pressure, and bounding pulse.
133
What is refeeding syndrome?
A potentially life-threatening metabolic complication characterized by heart failure, peripheral edema, rhabdomyolysis, seizures, and laboratory values indicating hypophosphatemia and hypokalemia.
134
What is the recommended action if complications arise during tube feeding?
Prevent, assess, and manage complications, and monitor for diarrhea and abdominal distention.
135
What should be done before and after medication administration via the tube?
Flush the tube with 30 mL of water.
136
What is an important consideration for patient comfort with an NG tube?
Provide frequent oral hygiene due to tube irritation.
137
What is the purpose of a nasoenteric tube (NET)?
To provide short-term feeding through a tube inserted nasally and advanced into the gastrointestinal tract.
138
What are common types of nasoenteric tubes?
* Nasogastric tube (NG) * Nasoduodenal tube (NDT) * Nasojejunal tube (NJT)
139
What is a gastrostomy tube?
A tube inserted through a surgically created opening in the abdominal wall into the stomach for long-term feeding.
140
What is a jejunostomy tube?
A tube placed through a surgically created opening between the jejunum and the abdominal wall for long-term feeding.
141
What is an indwelling urinary catheter?
A long-term catheter used for patients needing precise measurement of urine output or those with altered tissue integrity.
142
What is the risk associated with long-term catheter use?
Increased risk of urinary tract infections (UTIs).
143
Fill in the blank: A _______ tube is used for patients needing long-term enteral feeding and is placed through a surgically created opening directly into the GI tract.
Enterostomal feeding
144
True or False: Blue food dye should be used in enteral nutrition formulas.
False
145
What should be done with opened cans of enteral formula after 24 hours?
Discard any unused open cans.
146
What is the purpose of a dual-access gastrostomy-jejunostomy (PEG/J) tube?
To provide access to both the stomach and the jejunum through a single stoma.
147
What is the importance of marking the tube exit point after NG tube placement?
To serve as a baseline for visual re-evaluation of placement at each assessment.
148
What type of catheter is inserted through the abdominal wall into the bladder?
Suprapubic catheter
149
What is a Penrose drain used for?
To remove lymphatic fluid or other secretions postoperatively.
