Enteral Nutrition

Question 1

Gastric sump / nasogastric tube

Answer 1

Used for suction and feeding
-tip of tube sits in stomach with perferated holes
-holes on mouth end allowing hair into stomach but not fluids (for pressure)

Question 2

French sizes

Answer 2

BIGGER THE NUMBER BIGER THE TUBE

Question 3

Typical French size

Answer 3

14

Question 4

How long should a gastric sump stay in

Answer 4

2 weeks
-since the tube is relatively rigid, and this causes risk for break down in the nares

Question 5

Purpose of enteral suctioning

Answer 5

Emptying the stomach
-80 to 100 mmHg

Question 6

Why is intermeittant suctioning so important

Answer 6

It reduces risk/harm of suction on stomach wall

Question 7

Important to remember prolonged suction will

Answer 7

Upset the acid base balance in the stomach
-potassium chloride is given

Question 8

Potential complications

Answer 8

-erode stomach wall, would see blood being suctioned out
-aspirate
-dehydration and electrolyte loss
-dislodging tube

Question 9

Why does someone have a stomach suction

Answer 9

Bowel obstruction, bowel surgery to rest the bowel, intibated in ICU

Question 10

Soft borne feeding tubes

Answer 10

Tip of tube has weight (metal piece), place tube further than needed, peristalsis pulls tube down to jejum
-acid reflex, poor swallow, stomach is not absorbing (gastric bypass)

Question 11

Guide wire of the sort borne feeding tube

Answer 11

Allows for strength for insertion, runs down the tube
-without it would most likely coil at the back of the throat
-after placed and xrayed, guide wire is removed

Question 12

How long is a softborne tube left in

Answer 12

2 to 3 months

Question 13

Nasogastric vs nagojejunal

Question 14

PEG tube or PEJ tube

Answer 14

Deliver to small intestine, but goes directly through stomach wall
-very long term

Question 15

PEG/PEJ

Answer 15

Percutanoues (thru skin), endoscopic (camera involved), gastrostomy or jejunostomy

Question 16

Who receives the PEG/PEJ tube

Answer 16

Swallowing deficit, tumour obstructing, cancer, injuries, not awake enough

Question 17

PEG or PEJ requires

Answer 17

A functioning bowel/gastrostomy system

Question 18

Keep head of bed at

Answer 18

30 degrees

Question 19

What should we be checking for in the tube placement

Answer 19

-centimetre markings, taping
-testing of pH
-pushing air into tube
-withdrawal of stomach contents (syringe)

Question 20

Change equipment q

Answer 20

24h

Question 21

Numbers on feeding bags

Answer 21

How many calories on feeding bags
-underweight or fighting infection need higher

Question 22

Plugged tubes happen when

Answer 22

Occurs when not flushed properly
-need water in their system

Question 23

Start out slow with feeding..

Answer 23

30mL an hour
-increased once tolerated

Question 24

Assessments of stomach during a feeding tube

Answer 24

Distension, discomfort, nausea, burping, fullness

Question 25

Residuals

Answer 25

Suctioning stomach contents, if syringe fills up then they continue with another. Measuring how much mL they can pull up
-if there’s a lot left in stomach, might need to decrease rate in infusion

Question 26

Once you’ve checked residual

Answer 26

Once you’ve checked residual and they match the correct amount… you must push the fluid back into the patient. As it is full of important enzymes, nutrients and pieces.

Question 27

Bonus feed

Answer 27

Certain volume infused at lunch, supper and bedtime
-larger volume

Question 28

Feeding by gravity

Answer 28

Prolonged small portions fed to the patient continuously

Question 29

Stomach distension, diarrhea, constipation, can all be related to what two things concerning feed

Answer 29

Quantity of feed, or content of feed