Enteral Nutrition

Question 1

Upper GI Tract

Answer 1

Esophagus, Stomach, Duodenum

Question 2

Lower GI Tract

Answer 2

Most of the small intestine and the entire large intestine.

Question 3

Who requires enteral nutrition

Answer 3

• Swallowing disorders, certain bowel diseases, and the malnourished.
• Functioning GI Tract

Question 4

Open system

Answer 4

No greater than 4 hours

Question 5

Closed system

Answer 5

24-48 hours

Question 6

Nasogastric (NG) tube

Answer 6

Levin: small bore, single lumen
Salem Sump: large bore, double lumen
Dobhoff (nasoenteric): longer, small bore

Question 7

Gastrostomy Tubes

Answer 7

PEG: Nutrition is delivered through to the stomach through the abdominal wall

G button or Mic-Key button: level with the skin, inserted through abdominal wall into the stomach

Question 8

Enteral nutrition feeding schedules

Answer 8

Continuous
Gravity
Cyclic
Intermittent

Question 9

Continuous

Answer 9

constant distribution of nutrition evenly over 24 hours

Question 10

Gravity

Answer 10

continuous, no precise rate, maximum height of 18 inches above insertion site

Question 11

Cyclic

Answer 11

regularly, less than 24 hours

Question 12

Intermittent

Answer 12

regular/periodic (30-60 minutes), bolus method ( over 5-10 mins)

Question 13

Enteral Nutrition Feeding

Answer 13

Head of Bed (HOB) should be elevated to semi-fowler’s position (30-45°)

Question 14

Complications

Answer 14

• Aspiration
• Bacterial Growth
• Diarrhea, Nausea, Vomiting

Question 15

Nursing assessment

Answer 15

• Abdominal Assessment

* Confirm length of tube

Question 16

Verify tube placement

Answer 16

• VERIFY VERIFY VERIFY
• Gastric Residual Volume (GRV)
• Aspirate gastric contents and observe appearance
• Check pH of the contents using nitrazine paper

Question 17

Gastric

Answer 17

1 - 5.5 pH

Question 18

Gold standard

Answer 18

Obtain an X-RAY after initial insertion

Question 19

Subsequent feedings: More than one bedside method.

Answer 19

•Most facilities have policies in place regarding amount of residual
-Greater than 150 ml or greater than flow rate for 1 hour needs attention
•Re-instill the residual contents you aspirated back into the tube
-Depends on amount of residual & hospital policy (be familiar with hospital policy)

Question 20

Crushed meds via NG/PEG tubes

Answer 20

Dissolve powder in 20mL of water

Question 21

Giving several meds via NG/PEG tube

Answer 21

give each separately flushing with 20 to -30 mL water in between

Question 22

Prior to medication administration via enteral tube

Answer 22

Flush tube with 20 to 30 mL. of water

Question 23

ALERT

Answer 23

• A: Aseptic technique
• L: Label enteral equipment
• E: Elevate the head of bead
• R: Right patient, Right formula, Right tube
• T: Trace all lines back to patient

Question 24

Troubleshooting

Answer 24

• Prevention to maintain tube.

* Unless directed by healthcare professional do not use acidic solutions. Ex. Coca Cola

Question 25

feedings. The nurse knows to do which of the following when administering medications via an NG tube?

Answer 25

Administer each medication separately.