NG Tube Lab Flashcards
(20 cards)
Why/when would you utilize NG tube feedings?
Meet the nutritional needs of a patient when they:
- can’t swallow
- decreased appetite or malnourished
- mechanical ventilation and can’t aet orally
- paralytic illeus recovery
- need short term support (< 4 weeks)
How do you measure the NG tube length for a patient? What if you were aiming for the duodenum/jejunum?
- nose → earlobe/tragus → xiphoid process
-> Add 20–30 cm if aiming for duodenum/jejunum.
What is the gold standard for confirming NG tube placement?
- Chest X-Ray
What other test other than a Chest X-Ray can you use to verify NG tube placement? What characterisitics are you looking for?
- pH testing of aspirate
-> pH of 1-4; green/tan, watery aspirate - Capnometry test
-> detects CO2 at the tubes end
What position should hte patient be placed in prior to NG tube insertion?
- High Fowler’s
How often should you check gastric residuals?
- every 4 - 6 hours
What sized syringe should be used to check residuals?
- 50 - 60 mL
How much water should you use when you flush an NG tube? When should you flush an NG tube?
30 - 50 mL of water
- Before and after intermittent feedings
- At least every 4 hours during continuous feedings
- Before and after medication administration
- After checking residuals
When administering enteral nutrition, how should the patient be positioned? Why are they positioned like this?
- Head of bed must be >30 degrees
-> prevent aspiration
In order to prevent aspiration during enteral feeding, the head of the bed should be elavated more that 30 degrees. The head of the bed should stay elavated for _____ hour(s) after feeding
one
Describe the process of an aspirate pH test.
- Inject 30mL of air
- aspirate 5-10 mL
- Use pH paper (<4 = gastric juices)
- Return aspirate to stomach
- Flush with 30 mL water afterwards
In order to verify NG tube placement, Josh uses a Capnometry tool/test. The Capnometry indicates that it is postive for CO2. How should Josh proceed?
- a positive CO2 indicates the tube is in the lungs
-> remove the tube immediately
What should I do if I suspect aspiration or the client vomits while recieving an enteral feeding?
- Stop the feeding immediately
- Turn client on their side
- Perform nasotracheal/orotracheal suctioning
- Notify provider → may order chest X-ray
- Check gastric residual
What should I do if a feeding tube becomes clogged?
- Reposition the client (tube may be kinked)
- Flush with 30 mL warm water
- unclogging kits are available
-> If unsuccessful → tube must be replaced
A client developed diarrhea shortly after tube feedings were initiated. Is this due to the enteral feeding?
- Possible cause due to feeding delivered too quickly
-> Prevent by decreasing feedings slowly
A patient receiving enteral nutrition suddenly begins coughing and looks distressed. What steps should you take immediately to assess and respond to this situation?
- Stop the feeding immediately
- Assess for signs of aspiration (coughing, distress)
- Check tube placement (aspirate for pH, auscultate, or use capnometry if available)
You are about to administer 3 crushed medications through an NG tube. What is the safest way to administer them to prevent clogging?
- Dilute each crushed medication separately
- Flush with 15–30 mL of water between meds
- Use liquid forms when available
A patient on continuous enteral feeding has a history of aspiration. What nursing actions help reduce the risk of aspiration before, during, and after feeding?
- Verify tube placement before each feeding
- Elevate HOB to at least 30° during and 1 hour after feeding
- Check residuals regularly
- Assess bowel sounds
You are starting tube feedings for a severely malnourished patient. What is refeeding syndrome, and how do you prevent it?
Caused by a shift from protein to carb metabolism, leading to electrolyte depletion
- Prevention:
-> Check/correct electrolytes before feeding
-> Start slow, increase rate gradually
-> Monitor closely for arrhythmias, seizures, respiratory distress
