External Nutrition Flashcards
What is succtioning for
To get rid of secretion in peoples mouth
Indication for suctioning
Thick secretions
Weak cough
Generalized client weakness
Inability to clear secretions
gurggling
What is PPE for suctioning
Mask, gloves, eyewear
What is enteral nutrition
a tube that provides nutrients to the body
Gastrointestinal tube placement
in the stomach
J tube is placed
inserted in stomach ends in small intestine
PG tube
mushroom shaped device inside the stomach, may have a short tube or a long tube extending out of the stoma
Gastric button
lies flat on surface and an extension tube locks into the opening, held in place by a tater filled balloon in the abdomen
which tubes are good for Short term feeding
Nasogastric or orogastric
How are GJ tubes inserted
surgically
Types if tubes
nasogastric, nasoduodenal, gastostomy, nasojejunal, jejosomy
Enteral access devices
are feeding tubes placed directly into the GI tract to deliver nutrients as well as additional fluids and often is a method for delivering medications
Nasal or oral tubes
may be placed at the bedside, with endoscopy, or surgically.
6 types of feedings tubes
-nasogastric, orogastric, nasoenteric, gastomy, oreonteric, jejunomy
how long does formula last after being opened
24 hours refrigerated
percutaneous tubes include
gastrostomy, jejunostomy (these are inserted into the skin
Bolus
used for gastric feeding given to ambulatory patients given like meals by a syringe or gravity brief infusion time
Intermitten
used for gastric feeding given to ambulatory patients given at various time in a 24 hours period by gravity or pump over 20-60 mins
Continuous feeding
used for patients who cannot tolerate intermittent method given continuously by pump
where should HOB be when getting enteral nutrition
HOB 30-45 degrees
How often should we change tubing
every 24 hours
when to flush
30 mL before 4-6 hours intermittently during feeds and after
What to document
input and output
Average size of NG
8-18
When would we use a large NG
when needing to take content out instead of in
Indications for NG tubes
external feeding, decompression, compression, lavage, gastric analysis
Decompression
removal of secretions and gaseous substances from GI tract to prevent or relieve abdominal distention; used in post-op ileus, intestinal obstruction, and to decrease pressure of suture lines from fluid
compression
internal application of pressure by means of an inflated balloon to prevent internal bleeding
lavage
irrigation of the stomach in cases of active bleeding, poisoning or gastric dilation
Salem Sump
is the most commonly used NG tube
Duotube
is a smaller and more flexible Salem sump NG, more comfortable
Duotube cannot
decompress
things to assess with NG tube
Verify physician’s order
Two patient identifiers
Patient’s knowledge of procedure
Examine naris. Assess patency of nostrils
Note history of nasal surgery, allergies, deviated septum, nosebleeds, facial trauma, etc.
Determine whether the patient is on anticoagulation medication(s)
Assess LOC and ability to follow instructions
Perform physical assessment of abdomen
Placement
X ray, PH, Monitor external lengthh and observe for fluid aspirated
How to measure NG
nose, earlobe, Xiphoid
how often do we check for placement
every 4-6 hours and anytime we install anything
what is the stomachs resting Ph level
4-5
how long should you wait to suction after meds
30-60 mins
Possible complications that may occur
The feeding tube has come out of the abdominal wall.
There is leakage around the tube or system.
There is redness or irritation on the skin area around the tube.
The feeding tube seems blocked.
There is a lot of bleeding from the site of tube insertion.
Diarrhea after feedings
A hard, swollen belly 1 hour after the feeding
Worsening abdominal pain
Constipation and passing of hard, dry stools
Increased coughing more than normal or shortness of breath after feedings
Tube feed in the client’s mouth
Peristalsis
involuntary contraction and relaxation of longitudinal and circular muscles throughout the digestive tract,
