Unit 3: Nutrtition

Question 1

What reason(s) would the doctor order the insertion of a NG tube?

Answer 1

Gavage
Lavage
Decompression

Question 2

What is the purpose of the larger lumen on the Salem sump?

Answer 2

Larger Lumen: Drain gastric content

Question 3

What is the purpose of the smaller lumen on the Salem sump?

Answer 3

Smaller Lumen: allow entry of air.

Question 4

What type of lubricant is used for the insertion of a NG tube? Why?

Answer 4

Water based lubricant is used. Oil based lubricants are not absorbed by the body, and can cause infection if tubing enters the lungs.

Question 5

When inserting the NG tube into the naris, the nurses asks the patient to do what with their head/neck? Why?

Answer 5

Hyperextending the head/neck facilitates passage of the tube through the normal contours of the nasal passage.

Question 6

When the tubing reaches the throat, the nurse asks the patient to _______ their head/neck. Why?

Answer 6

Flexing (tilting head down) facilitates passage of tubing into the posterior pharynx.

Question 7

What signs of respiratory distress does the nurse assess for during insertion of a NG tube.

Answer 7

Gasping
Coughing
Cyanosis
Inability to speak

Question 8

How is NG tube placement verified?

Answer 8

XRay
Auscultation (while inserting air)
Checking pH of gastric content/residuals.

Question 9

What is the primary advantage of continuous drip tube feedings?

Answer 9

Gradual introduction of forumla –> optimal absorption of nutrients.

Question 10

The removal iof pressure caused by gas or fluids in the stomach is called _______.

Answer 10

Decompression.

Question 11

A patient returns from surgery, and has a NG tube running with low intermittent suction. The patient asks why it is necessary to remove the fluids/gas. How does the nurse respond?

Answer 11

Decompression promotes healing after surgery by preventing post-operative vomiting and distention caused by reduced peristalsis.

Question 12

The nurse assessing for bowel sounds on a patient with suctioning running through and NG tube should do what before auscultating?

Answer 12

Suction is turned off prior to assessing for bowel sounds.

Question 13

The process of washing out and organ is referred to as ______.

Answer 13

Lavage

Question 14

Why is lavage ordered?

Answer 14

Removal of unabsorbed poisons, diagnose gastric hemorrhage or remove liquid/small particles from the stomach.

Question 15

Name the three types of NG tubes.

Answer 15

Levin
Salem Sump
Small Bore

Question 16

Which NG tube is useful for short term gavage or lavage?

Answer 16

Levin

Question 17

Which NG tube contains a double lumen?

Answer 17

Salem Sump

Question 18

Which NG tube allows for an inflow of air? What is the purpose of the inflow of air?

Answer 18

Salem Sump

Prevents vacuum so gastric tube does not adhere to stomach wall.

Question 19

Which NG tube is used for decompression?

Answer 19

Salem Sump

Question 20

Which NG tube contain a stylet the stiffens the tube for insertion?

Answer 20

Small Bore

Question 21

Which NG tube is often used for extended periods of Gavage?

Answer 21

Small Bore

Question 22

Which NG tube can be left in for an extended period of time with less irritation to the nasopharyngeal, esophageal, and gastric mucosa?

Answer 22

Small Bore

Question 23

What type of tube is used when long term gavage is likely?

Answer 23

Gastrostomy tube.

Question 24

Why is a PEG tube considered safer?

Answer 24

Does not require a general anesthetic when inserted by the physician.

Question 25

What nursing care is included for patients with G tubes?

Answer 25

Nursing care includes inspecting the insertion site at least every shift.

Question 26

When are dressings used with G tubes?

Answer 26

A dressing is usually only used immediately after the procedure or if there is any drainage.

Question 27

What does the physician prescribe in regards to feedings?

Answer 27

Rate of infusion | Formula to be used.

Question 28

Which method(s) of feeding reduces the risk of abdominal distention?

Answer 28

Continuous pump feedings | Intermittent gravity feedings

Question 29

What type of feeding uses a syringe to deliver the formula quickly to the stomach?

Answer 29

Intermittent Bolus feedings.

Question 30

What complications should the nurse be assessing/preventing when the patient is receiving tube feedings?

Answer 30

Nausea, Vomiting, Aspiration, Fluid/Electrolyte imbalance, Diarrhea, intestinal cramping, and tube occlusion.

Question 31

When do nausea, vomiting, and aspiration occur in regards to tube feedings?

Answer 31

When feeding is administered at a rate faster than the formula can be absorbed.

Question 32

How does the nurse assess that the formula is being absorbed?

Answer 32

Check the residual volume.

Question 33

The nurse is preparing to administer an intermittent feeding. The nurse checks the residuals, and notes there are 120mL of residuals. The previous feeding was 200mL. How does the nurse proceed?

Answer 33

Since the residuals are greater than half the previous feeding, the current feeding should be held. Reassess at the next scheduled feeding.l

Question 34

The nurse is assessing the patient receiving a continual feeding. When checking the residuals, the nurse notes residual content is 45mL. Should feeding continue?

Answer 34

Yes. Continual feeding can continue as long as the residuals are less than 100mL.

Question 35

What does the nurse assess prior to administering a bolus feeding?

Answer 35

Placement via auscultation and residuals. Bowel sounds Abdominal Distention Residual <50% previous feeding.

Question 36

How often should the nurse assess proper tube placement?

Answer 36

Q4H

Question 37

How is aspiration prevented for patients receiving feedings?

Answer 37

Verify placement Q4H | Keep patient in Fowlers (or Right side if unable to tolerate Fowlers) during and 30 following feeding.

Question 38

High osmolarity formulas can cause:

Answer 38

Diarrhea, intestinal cramping, and fluid loss.

Question 39

How are severe osmotic shifts prevented?

Answer 39

Diluting formula | Flushing tube with 30-60ml of water q4h.

Question 40

How is GI intolerance limited?

Answer 40

Slow adminitration | Room Temperature Feeding

Question 41

How does the nurse prevent tubing from becoming clogged?

Answer 41

Frequent flushing with water.

Question 42

How much formula should be poured into a feeding bag at one time for patients receiving continuous feedings?

Answer 42

Pour only enough formula that will infuse in 4-6 hours to prevent bacterial growth

Question 43

How often is tubing/bagging changed?

Answer 43

q24h

Question 44

How often is the syringe changed?

Answer 44

q24h

Question 45

What is documented in regards to tube feeding?

Answer 45

``` The check for placement. Amount of residual. Amount and kind of solution administered. Duration of the feeding. Patient's response to feeding. Assessment of the patient. ```

Question 46

Aside from the amount of feeding administered, what other item does the nurse include in the pt's I&O record?

Answer 46

Amount of H20 used to flush tube.

Question 47

What does the physician order in regards to Glucose Monitoring?n

Answer 47

Time and Frequency of glucose monitoring.

Question 48

When is glucose monitoring typically performed?

Answer 48

Morning, Night, and Before Meals

Question 49

What diagnostic study is done to evaluate the function of the esophagus?

Answer 49

Swallowing Studies

Question 50

What is measured during a swallowing study?

Answer 50

Pressure in the esophagus during swallowing.

Question 51

What do the waves look like for normal swallowing in a swallowing study?

Answer 51

Normal swallowing registers a rapid rise and fall in pressure in the esophagus.

Question 52

What do the waves look like for abnormal swallowing in a swallowing study?

Answer 52

No swallowing waves or strong propulsive waves.

Question 53

Is sedation used for swallowing studies?

Answer 53

No, sedation can cause a drop in esophageal pressure.

Question 54

What diagnostic study uses barium to visualize the soft tissues of the gastrointestinal tract?

Answer 54

Upper Gastrointestinal Study or Barium Swallow

Question 55

How is Barium administered in an upper gastrointestinal study/Barium swallow?

Answer 55

Barium is swallowed.

Question 56

How long should the patient fast before receiving an upper gastrointestinal study / barium swallow?

Answer 56

8-12 hours.

Question 57

How much barium mixture is used for an upper gastrointestinal study / barium swallow.

Answer 57

16-20 oz of barium mixture.

Question 58

What should be monitored following an upper gastrointestinal study / barium swallow? Why?

Answer 58

Bowel Movement, Barium causes Constipation.

Question 59

The patient tells the nurse their stool was chalky colored following their Upper Gastrointestinal Study. Is this normal?

Answer 59

Yes.

Question 60

What diagnostic study allows for visualization of the lining of the esophagus, stomach, and duodenum?

Answer 60

Esophagogastroduodenoscopy (EGD)

Question 61

How long must the patient fast before an EGD?

Answer 61

8-12 hours

Question 62

Which diagnostic study allows for the use of twighlight sleep?

Answer 62

EGD

Question 63

What position is the patient in for an EGD?

Answer 63

Left Lateral recumbent position.

Question 64

What is air used to during and EGD?

Answer 64

Allow for better visualization of the GI tract.

Question 65

How is gag reflex assessed post EGD?

Answer 65

Touching the back of the throat with a tounge blade.

Question 66

How is a sore throat soothed following an EGD?

Answer 66

Throat lozenges or warm saline gargle.

Question 67

What are the possible causes of difficulty chewing?

Answer 67

Ill-fitting dentures, gingivitis, dental caries, and oral surgeries.

Question 68

Why is difficulty chewing a concern?

Answer 68

People who have difficulty chewing may have trouble eating enough nutrients.

Question 69

What are the possible causes of difficulty swallowing?

Answer 69

Gag reflex is absent due to CVA, or muscle weakness. Obstruction to oropharnyx secondary to tumor or edema.

Question 70

Define Anorexia:

Answer 70

loss of appetite.

Question 71

What are the possible causes of anorexia?

Answer 71

Depression, GI dyfunction, illnesses, malignancies and side effects of many medications. Discomfort before or after eating.

Question 72

Name the factors that can affect INGESTION

Answer 72

Difficulty Chewing Swallowing Impairment/Dysphagia Change in Food Intake/Anorexia

Question 73

Name the factores affecting DIGESTION

Answer 73

Obstruction of the GI tract.

Question 74

What type of diet would a patient who has an active GI obstruction be placed on?

Answer 74

NPO... Intestinal obstructions usually necessitate withholding all oral intake until the obstruction has been resolved or surgically corrected.

Question 75

What causes malabsorption syndromes?

Answer 75

The inability to tolerate certain foods.

Question 76

What are the possible causes of abdominal distention?

Answer 76

Constipation, intestinal inflammation, excess flatulence.

Question 77

What are the possible causes of Nausea and Vomiting?

Answer 77

Food allergy, medications, stomach disorders

Question 78

What are the possible causes of hyperactive bowel sounds?

Answer 78

Diarrhea, gastroenteritis.

Question 79

What are the possible causes of hypoactive bowel sounds?

Answer 79

manipulation of the bowel during surger or peritonitis.

Question 80

Diarrhea, stress and HYPERthyroidism can cause weight ______..

Answer 80

Weightloss.

Question 81

HYPOthyroidism, depression, and anxiety can cause weight______.

Answer 81

Weightgain.

Question 82

Poor wound healing may be a sign of poor absorption of _____ __, ________ and _______.

Answer 82

Vitamin C, Protein, Zinc

Question 83

Poor _____ _______ is a sign of hypovolemia.

Answer 83

Skin Turgor

Question 84

What would a nurse look for in a patient who with poor Iron intake?

Answer 84

Confusion

Question 85

Define: Cholecystectomy:

Answer 85

Excision of the gallbladder.

Question 86

Define: Deglutition

Answer 86

Act of swallowing.

Question 87

Define: Dyspepsia

Answer 87

Indigestion

Question 88

Define: Dysphagia

Answer 88

Difficulty swallowing

Question 89

Define: Eructation

Answer 89

Act of belching

Question 90

Define: Gastrectomy

Answer 90

Partial or complete removal of the stomach

Question 91

Define: Hematemesis

Answer 91

Vomiting blood.

Question 92

Define: Stomatitis

Answer 92

Inflammation of the mouth.

Question 93

How does the nurse clear gastric content from the NG tube when removing the NG tube?

Answer 93

Flush with 20mL's of air.

Question 94

What is the NG tube flushed with air prior to removal instead of water?

Answer 94

Prevent aspiration.

Question 95

What should the nurse intruct the patient to do just prior to NG tube removal?

Answer 95

Take a deep breath and hold it..

Question 96

A normal Fasting Blood Sugar range for adults is ____ - _____.

Answer 96

70-99

Question 97

Between meals, a normal blood sugar range is ___ - ___.

Answer 97

80-120

Question 98

What type of nutrion is provided via IV?

Answer 98

Parenteral