Ch 12: Enteral Access Devices Flashcards
What is the difference between a nasoenteric and a nasojejunal feeding tube??
Nasoenteric feeding tubes are placement distal to the pylorus, whereas nasojejunal tubes are placed distal to the ligament of Treitz
How are feeding tube diameters reported?
By the tube’s external diameter measurement
What should be used first to unclog a feeding tube?
Pancreatic Enzymes
When are gastrojejunal systems used?
GJ systems, which allow for simultaneous gastric decompression and small bowel feedings may be indicated for gastric outlet obstruction, severe GERD, gastroparesis and early post op feeding
What are the internal retention bolsters of percutaneous tubes are constructed of and what are the benefits of each type?
Solid material (silicone or polyurethane) or slicone balloons.
Solid internal bolsters are more common w/ initial percutaneous placements b/c they have greater longevity.
Balloon type internal bolsters are inserted more commonly with radiologic and surgical tube placement and they are used as replacement devices in the office setting b/c of their ease in placement
What is the gold standard for checking placement of nasogastric/nasoenteric tubes
Plain abdominal or chest radiography is the gold standard for confirmation of placement; however, recent studies suggest that radiographic confirmation may not be required with electromagnetic imaging technology is used for placement by an experience tube team with demonstration of success
When would an a gastric or nasoenteric feeding tube placement be contraindicated?
If the patient has an obstructing head, neck, and esophageal pathology or injury that prevents safe insertion
What are most feeding tubes made out of and what are the benefits of each?
Polyurethane or silicon. Most nasogastric or nasoenteric tubes are made of polyurethane b/c it allows for a relatively larger inner tube diameter for a given out diameter size
Most percutaneous tubes are constructed from silicone b/c of its inherent material longevity and comfort
What is buried bumper syndrome?
Buried bumper syndrome occurs when the internal bumper of a gastrostomy tube erodes into the wall of the stomach.
What is the most common complication of a gastrostomy placement?
Peristomal infection
What is the time frame for safe removal of an enterostomy tube?
Enterostomy tubes can be safely removed/replaced after the stoma tract has matured. Although maturation usually occurs 1-2 weeks after initial placement, many clinicians prefer to wait 4-6 weeks prior to removal
What are the contraindications for endoscopic gastrostomy placement?
Obstruction of the GI tract proximal to the stomach and inability to trans illuminate the abdominal wall for identification of a safe abdominal access site, ascites, coagulopathy, gastric varices, active head and neck CA, morbid obesity, and neoplastic, infiltrative, or inflammatory disease of the gastric or abdominal wall
Which type of lock can be used in silicone based catheters?
Ethanol
The use of 0.1N hydrochloric acid is most effective for clearing catheter occlusions due to precipitation of what?
Calcium Phosphate
For catheter occlusions due to precipitates associated with medications in the high pH range such as Tobramycin and phenytoin, _____ has been anecdotally reported to be effective
Sodium bicarbonate
