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Health Differences > Enteral Nutrition > Flashcards

Enteral Nutrition Flashcards

1
Q

how long can a closed feeding system be used?

A

for up to 48 hrs

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2
Q

Enteral nutritional formula containing intact protein, carb and fat molecules that requires pt to have normal digestion and absorption.

A

Standard formula

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3
Q

Low profile device used for long term feeding in kids and active patients because of minimal external apparatus

A

LPGD (low profile gastrostomy device)

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4
Q

high residual volumes are known to increase what risk

A

residual volumes greater than 200-250 mL are associated with increased aspiration risk

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5
Q

When pt is in need of long term nutritional support a tube may be placed directly into the ____ or the ____.

A

Stomach (g-tube)

Jejunum (j-tube)

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6
Q

How to measure for NI tube placement

A

Measure just like an NG tube (nostril to ear lobe to iPhone process) and then add 8”-10”

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7
Q

Always check ___ ___ before giving meds or feeding down tube

A

Tube placement

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8
Q

Use of a g-tube or PEG tube requires a…

A

Intact, fully functioning GI tract

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9
Q

pH of stomach

A

Less than 5.5

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10
Q

Starting feeding at a slower rate and advancing improves…

A

Pt tolerance

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11
Q

during feedings, pt should be positioned how?

A

with their head as upright as possible during feeding and for at least an hour after feeding

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12
Q

Normal airway ETCO2

A

35-45 mmHg

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13
Q

NI tube

A

Nasointestinal tube

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14
Q

Intestinal feedings are continuous to prevent…

A

Dumping syndrome

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15
Q

Flush tube regularly with ___ after checking residual to prevent occlusion.

A

Warm water

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16
Q

Hydrolyzed enteral formula

A

Macronutrients are already broken down into simpler forms that require little or no digestion.

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17
Q

Consult the physician of residual is greater than

A

400 mL

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18
Q

Residual

A

Amount of feeding still in the stomach

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19
Q

can you add meds to formula?

A

no

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20
Q

NG tube placement confirmation techniques

A
  • radiograph (X-Ray)
  • visual assmt of aspirate
  • pH of aspirate
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21
Q

Prior to aspirating GI contents you should…

A

Insert 30 mL of air into the tube

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22
Q

Pt position while inserting NI tube

A

pt should be on right side

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23
Q

when giving meds, when do you flush with water?

A

before given meds, between meds and after giving meds

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24
Q

how to measure NG tube for insertion

A

measure tube from nostril to ear lobe to tip of xiphoid process. Mark the tube with a permanent marker.

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25
Q

Continuous feeding for a portion of a 24 hour period (i.e. Overnight)

A

Cyclic feeding

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26
Q

Why do you never use the plunger when you’re when feeding patient using a large syringe?

A

Because administering a feeding too fast can cause G.I. distress

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27
Q

pH of airway

A

6.0 or higher

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28
Q

can meds be given through NG tubes?

A

yes, but not during feedings

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29
Q

Research recommendations for tube feeding in pts with dementia

A

Research recommends tube feedings not be used for this population because they do not increase survival or decrease aspiration risk or prevent malnutrition

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30
Q

during insertion, if there are signs of resp distress, excessive gagging, coughing, cyanosis, inability to speak or hum, etc, you should…

A

discontinue procedure and remove tube because it may be in the airway

31
Q

Type of enteral feeding utilizing a gradual introduction of food for maximum apportion.

A

Continuous feeding

32
Q

When using a feeding pump how often should you check tube placement and measure residual?

A

q 4-6 hrs

33
Q

when advancing the tube past the pharynx, you should temporarily stop advancing when the pt ___ to avoid the airway

A

breathes

34
Q

If there is a long term feeding situation and a G tube or PEG tube can’t be used because GI tract is not fully functioning, you would place a ____

A

J-tube

Jejunostomy

35
Q

Measurement for NI tube placement

A

measure just like an NG tube (nostril to ear lobe to xiphoid process) and then add 8”-10”

36
Q

If CO2 is present, NG tube is in the ____.

A

Airway

37
Q

Can be used to place a tube in the stomach without the use of general anesthesia.

A

PEG

percutaneous, endoscopic gastrostomy

38
Q

Parenteral nutrition

A

Nutrition via IV therapy

39
Q

Since infants are obligate nose-breathers, you may use what kind of tube instead of an NG tube?

A

OG tube (orogastric tube) through the mouth

40
Q

preferred type of meds to give through NG tube

A

liquid whenever possible

41
Q

common complications of enteral feedings

A 
clogged tube
aspiration
nasal erosion (with NG or NI tubes)
diarrhea, nausea, vomiting, distention
unplanned extubation
stoma infection
42
Q

Jejunum

A

The part of the small intestine between the duodenum and the ileum.

43
Q

Before beginning feeding, you should always…

A

Verify tube placement with multiple techniques, aspirate all gastric contents to measure residual, push residual back through tube and flush with 30 mL of water

44
Q

NG feeding contraindications

A 
Dysfunctional gag reflex
Aspiration risk
GERD
Nasal injuries
Unable to sit with head elevated at meal time
45
Q

to secure tube…

A

tape tube to nostril and cheek and then have pt turn head to opposite side from tube and secure tube to gown.

46
Q

Pt position for NI tube insertion

A

Position pt on right side

47
Q

Med that increases GI motility

A

Reglan (metoclopramide)

48
Q

How long should patient remain sitting upright after tube feeding?

A

At least one hour

49
Q

if you meet resistance while advancing the tube…

A

do not force the tube and rotate it back and forth while gently trying to advance it.

50
Q

Research recommendations on what therapies to use with dementia pts instead of tube feeding

A

Increased feeding assistance

Changing food consistency

51
Q

reusable feeding systems should be cleaned how often?

A

every 24 hours with soap and hot water

52
Q

NG tube

A

Nasogastric tube

53
Q

Preferred and most effective method of feeding pts?

A

Oral feeding

54
Q

after checking residual, you should do what to prevent tube occlusion?

A

flush with water

55
Q

Next best thing if oral feeding is not possible

A

Enteral nutrition/feeding

56
Q

Best check for G tube or J tube placement

A

Measurement of excess tube length

57
Q

Enteral feedings preferred for feedings into the intestine

A

Continuous feedings

58
Q

Syndrome caused by introducing too much food into the intestine at once. Causes nausea, distention, diarrhea, cramping and lightheadedness.

A

Dumping syndrome

59
Q

before opening a can of fluid you should always…

A

check the expiration date and disinfect the rim

60
Q

pH of intestines

A

7.0 or higher

61
Q

“Gold standard” of NG verification

A

X-Ray (radiograph)

62
Q

when inserting an NG and the tube reaches the pharynx, you should have pt…

A

touch chin to chest and sip water through a straw or swallow if NPO

63
Q

In what way does continuous feeding alter the pH of the stomach?

A

Nutritional formula acts as a buffer and can make GI readings higher on the pH scale (alkalodic)

64
Q

When using a large syringe (open system) how can you control the speed of the flow?

A

Since there is no plunger and the system is open, use gravity to adjust the flow rate by raising or lowering the syringe

65
Q

when NG or NI tube is in place, perform oral hygiene every…

A

2-4 hrs

66
Q

During, and for one hour after feeding, pt should remain as upright as possible, at what minimum angle?

A

Pt should sit up to at least a 30-45 degree angle

67
Q

How is an NI tube inserted?

A

It’s usually placed in the stomach and allowed to advance via peristalsis through the pyloric sphincter into the intestines

68
Q

other uses for NG tube besides feeding

A 
decompression of stomach 
drain fluid
remove poison or meds from stomach
monitor GI bleeding
prevent intestinal obstruction
69
Q

An ____ in excess tube length could mean the tube is dislodged

A

Increase

70
Q

Check residual…

A

before feedings and every four to six hours during continuous feedings

71
Q

ways to confirm NG/NI tube placement

A

X-ray, visualize aspirate, test pH of aspirate, check for presence of CO2. Make sure pre-measured mark is at the nostril.

72
Q

If inserting an NG tube and coughing and gagging persist you should…

A

stop advancing and check placement with a tongue blade and flashlight

73
Q

Enteral nutrition

A

Putting nutrients directly into the stomach

74
Q

when pt has an NG tube in place, perform oral hygiene how often?

A

q 2-4 hrs

Health Differences (7 decks)

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