Gastric Decompression Flashcards

1
Q

purpose of NG tube

A
  • to decompress or drain stomach of fluid/gastric secretions
  • instill solutions like meds and feedings into stomach
  • used for pt with conditions when peristalsis is absent
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2
Q

reasons for decompression

A
  • rest GI tract
  • clear GI tract
  • Pt is NPO
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3
Q

why would a pt need to rest the GI tract

A

-severe vomiting and diarrhea
-diverticulitis, Crohn’s
Monitor GI bleed

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4
Q

why a pt need to clear the GI tract

A
  • treat distention
  • intestinal obstruction
  • paralytic ileus
  • promote healing
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5
Q

types of nasogastric tubes

A
  • levine tube(single lumen)

- salem sump (2 lumen)

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6
Q

levine tube

A

lacks venting system
mucosal damage can occur when suction is applied
suction is applied intermittently

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7
Q

Salem sump tube

A
  • double lumen
  • clear lumen: empties stomach content
  • blue lumen: provides continuous flow of air to prevent the clear lumen from pulling stomach lining into tube opening thus preventing gastric mucosal damage
  • one way anti reflux vlave may be used in the air flow lumen to prevent reflux of gastric content thru the airflow lumen
  • pressre causes the valve to close preventing contents from leaking out the blue
  • irrigate with normal saline
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8
Q

enteral nutrition: short term feeding: Nasogastric tube

A
  • nose to stomach

- no for long term feeding

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9
Q

internal nutrition: short term feeding: n’as-duodenal tube

A
  • Nose to duodenum

- thin and flexible tube

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10
Q

enteral nutrition: enterostomal tube: gastrostomy tube

A
  • surgically inserted into stomach from abdominal wall

- use 2-3 days after insetion

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11
Q

enteral nutrition: enterostomal tube: percutaneous endoscopic gastrostomy

A
  • inserted into stomach from abdominal wall
  • insertion does not require general anesthesia
  • use within hours of insertion
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12
Q

enteral nutrition: enterostomal tube: percutaneous endoscopic jejunostomy

A
  • inserted into jejunum form abdominal wall

- use with stomach problem and delayed gastric emptying

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13
Q

Enteral feeding: feeding infusion: continuous

A

always used for intestinal feedings

-pump limits mobility

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14
Q

internal feeding: feeding infusion: intermittent

A
  • resembles normal eating schedule

- permits more flexibility and mobility

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15
Q

does a person need to be NPO to have enteral feedings

A

Can be NPO or not

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16
Q

common complications of feedings and NGT

A
  • aspiration
  • clogged tube
  • nasal erosion
  • diarrhea
  • unplanned removal
  • stomach infection (GT)
  • dumping syndrome
17
Q

what causes dumping syndrome

A
  • feeding is too cold
  • feeding is too rich
  • delivery to intestines is too fast
18
Q

how to prevent complications of feedings

A
  • check residual, do not routine discard

- check mark with inedible ink

19
Q

caring for NG/NI tubes and PEG

A
  • secure tube to nose and gown
  • assess site placement and inflammation
  • sire care: cleanse peristomal skin and use skin barrier
  • rotate guard 360 degrees QD (daily)
20
Q

caring for NG/NI tubes and PEG

A
  • secure tube to nose and gown
  • assess site placement and inflammation
  • sire care: cleanse peristomal skin and use skin barrier
  • rotate guard 360 degrees QD (daily)
21
Q

inserting NG Tubes

A
  • prea assesment
  • measure nose to tip of ear lobe to xiphoid
  • position 45-90 degrees
  • advance tube : watch for coughing and signs of distress
  • secure tube and mark with indelible marker
22
Q

Assessing and confirming placement

A

-apiration: color
-capnometer: measure CO2
-air insertion
measure length of exposed tubing
-assess pH (less than 5.5)
-chest x ray(only initially)

23
Q

caring for NG tube

A
  • abdominal assessment
  • monitor gastric output
  • asses adeque of suction pressure: no drainage and n/v
  • maintina tube patency
  • anti reflux valve
  • oral hygiene
24
Q

NG irrigation

A
  • positon 30-45 degrees
  • instill irrigate slowly
  • subtract irritant from NG output
  • inject air into vent
25
Q

documentation of NG tube

A
  • type and size of tube
  • nare used
  • method of placement confirmation
  • patient response to care measures
  • teaching that was done
26
Q

tubes used for continuous suction

A

-salem sump tube

27
Q

tubes used for intermittent suction

A
  • salem sump tube

- levine tube

28
Q

suction

A
  • use lowest suction possible
  • provide will order intermittent or contious
  • pigtail must be above level of stomach
29
Q

intermittent suction order

A

80mmHg- 100mmHg

30
Q

continuous suction order

A

60-100mmHg

31
Q

removing NG tube

A
  • assessment: explain procedure, unsecured tube
  • placement: marker or pH
  • flush with 30-50mL of air
  • comfortable positioning
  • instruction to hold breath to avoid aspiration
  • give tissues and emesis basin
32
Q

documentation

A
  • condition of nare skin
  • I and Os
  • tolerance of procedure
  • patient teaching: abdominal pain, n/v, bloating