Ch.29 Gastric Intubation

Question 1

A(n) ____________ is an artificial opening into the stomach.

Answer 1

Gastrostomy

Question 2

Gastric ____________ tubes are used exclusively to remove fluid and gas from the stomach.

Answer 2

Sump

Question 3

Belching often indicates that the tip of the tube is still in the ____________.

Answer 3

Esophagus

Question 4

A(n) ____________ decompression tube is inserted in the same manner as a nasogastric tube.

Answer 4

Nasointestinal

Question 5

Intestinal tubes like the Maxter tube and the Andersen tube are weighted with ____________.

Answer 5

Tungsten

Question 6

A(n) ____________ tube is used in an emergency to remove toxic substances that have been ingested.

Answer 6

Orogastric

Question 7

Some nasogastric tubes have more than one ____________ within the tube.

Answer 7

Lumen

Question 8

A gastrostomy tube is placed surgically or with the use of a(n) ____________.

Answer 8

Endoscope

Question 9

A(n) ____________ feeding usually involves 250 to 400 mL formula per administration.

Answer 9

Bolus

Question 10

____________ generally means the placement of a tube into a body structure.

Answer 10

Intubation

Question 11

Identify the image.

Answer 11

The figure shows the method of obtaining the NEX measurement.

Question 12

How is this procedure performed?

Answer 12

Before inserting a tube, a nurse should obtain the client’s NEX measurement (the length from the nose-to-the-earlobe-to-the-xiphoid process) and mark the tube appropriately. The first mark on the tube is made at the measured distance from the nose to the earlobe. It indicates the distance to the nasal pharynx, a location that places the tip at the back of the throat but above where the gag reflex is stimulated. A second mark is made at the point where the tube reaches the xiphoid process, indicating the depth required to reach the stomach.

Question 13

Identify and label the image.

Answer 13

The figure shows the nasogastric intubation pathway.

Question 14

What are the disadvantages of this Nasogastric intubation?

Answer 14

Because nasogastric tubes remain in place for several days, clients complain of discomfort in the nose and throat. If the tube’s diameter is too large or pressure from the tube is prolonged, tissue irritation or breakdown may occur. Furthermore, gastric tubes tend to dilate the esophageal sphincter, a circular muscle between the esophagus and the stomach. The stretched opening may contribute to gastric reflux, especially when the tube is used to administer liquid formula. If gastric reflux occurs, the liquid could enter the airway and interfere with respiratory function.

Question 15

Meets total nutritional needs.

Answer 15

Balanced

Question 16

Furnishes more protein than other formulas

Answer 16

High nitrogen

Question 17

Provides nutrition and decreases constipation or diarrhea

Answer 17

High Fiber

Question 18

Given to people with malabsorption syndromes

Answer 18

Partially hydrolyzed

Question 19

Supplements nutrition without altering water distribution

Answer 19

Isotonic Balanced

Question 20

Presented here, in random order, are steps that occur during the assessment of the pH of aspirated fluid. Write the correct sequence in the boxes provided.

1. Aspirate a small volume of fluid with a clean syringe.
2. Perform an alcohol-based hand rub.
3. Compare the color on the test strip with color guide.
4. Drop a sample of gastric fluid onto an indicator strip.

Answer 20

2. Perform an alcohol-based hand rub.
3. Aspirate a small volume of fluid with a clean syringe.
4. Drop a sample of gastric fluid onto an indicator strip.
5. Compare the color on the test strip with color guide.

Question 21

Why is intubation performed on clients?

Answer 21

Intubation basically means the placement of a tube into a body structure. Intubation is performed on a client to remove gas or fluids, or to administer liquid nourishment.

Question 22

What are the problems faced with narrow-diameter feeding tubes?

Answer 22

Narrow tubes tend to curl during insertion because they are very flexible. Therefore, some are supplied with a stylet that helps to straighten and support it during insertion. Almost all have a weighted tip that helps the tube to descend past the stomach. Checking the placement of the distal end is more difficult; these tubes also become obstructed more easily.

Question 23

What are the nurse’s functions regarding nasogastric tubes?

Answer 23

Usually, nurses insert nasogastric tubes. Additional nursing responsibilities include keeping the tube patent or unobstructed, implementing the prescribed use, and removing the tube when it has accomplished its therapeutic purpose.

Question 24

When are tube feedings performed?

Answer 24

Tube feedings are used when clients have an intact stomach or intestinal function but are unconscious, have undergone extensive mouth surgery, have difficulty swallowing, or have esophageal or gastric disorders.

Question 25

What are the problems associated with bolus feedings?

Answer 25

A bolus feeding is the least desirable because it distends the stomach rapidly, causing gastric discomfort and increased risk of reflux. Some clients experience discomfort from the rapid delivery of this quantity of fluid. Clients who are unconscious or who have delayed gastric emptying are at a greater risk of regurgitation, vomiting, and aspiration with this method of administration.

Question 26

How can a dietitian help a tube-fed client in a home setting?

Answer 26

In home and long-term care settings, registered dietitians may be helpful in the ongoing assessment of tube feedings. For older adults living on a fixed income, dietitians can suggest ways to prepare less costly, home-blended formulas that meet the client’s nutritional needs.

Question 27

A nurse is administering a tube-feeding formula to a senior client with severe abdominal pain. The client also experiences malabsorption syndromes.

What should the nurse do if the senior client develops hyperglycemia when tube-feeding?

Answer 27

If a senior client has developed hyperglycemia, the nurse should instill diluted formula and gradually increase the concentration. Most tube-feeding formulas are highly concentrated; therefore, the hydration status of the older client must be closely monitored. If a senior client is receiving tube feedings with full-strength formula concentrations, it is important to check capillary blood glucose at intervals until the client’s results are within normal range.

Question 28

Which tube-feed formula should the nurse administer to the older client?

Answer 28

Tube-feeding formulas may vary based on the older client’s condition. Several lactose-free tube-feeding formulas on the market today may be beneficial to senior clients who experience malabsorption syndromes. Clients at risk for pressure sores benefit from formulas fortified with zinc, protein, and other nutrients.