GI Lab Flashcards
What things should you avoid 1-2 days before Guiac testing
Red meats and things that would make test turn +
What does Guiac Testing test for
Occult blood
What color does a positive Guiac test turn
Blue
What should you confirm with females before Guiac testing
That they are not mensturating
What should stool specimens not be contaminated with
Urine
C&S or ova and parasites Solid stool: Liquid stool: Container: To lab:
Solid stool: 1 inch of solid stool
Liquid stool: 15-30 ml
Container: should be sterile
To lab: immediately, needs to be warm
What do enemas stimulate
Peristalsis using high volume or irritating solution
Enemas are the installation of liquid into the ______and ________
Rectum and sigmoid colon
What type of enema would you not give somebody with CHF
Tap water. They would gain fluid
Characteristics of tap water enema
High volume hypotonic; water leaves bowel and enters interstitial space; risk of fluid overload
Normal saline enema characteristics
High volume; isotonic; no fluid exchange
Characteristics of soap suds enema
Intestinal irritant added to either tap water or normal saline
Characteristics of a fleet enema
Low volume; irritating hypertonic solution; pulls fluid into bowel, causing distention; not for dehydrated patients
How is a oil retention enema different
Client instructed to retain as long as possible- at least 30 min up to 2 hours
What does the oil retention enema do
Lubricates rectum & colon; feces absorb oil & soften
What would be done before a big surgery to make sure no stool in bowel
“Enemas until clear”
Give cleansing enema until only clear fluid expelled, no more than 3
What do you use to lubricate for a enema
Water soluble lubricant
How far do you insert for an enema
3-4 inches . You have to get past sphincter for liquids to stay in
What is procedure for Fleets & Pre-packaged enemas
Squeeze container until empty
Procedure for giving a volume enema
- Warm solution to 100-105 degrees F
- prime tubing
- bag held MAX of 24 inches above hips
- NEVER on an IV pole
- instill slowly
What will happen if you put a enema in fast
Cramps
Indications of digital removal of stool
Impacted mass
What can digital removal of stool cause
Irritation, bleeding, vagal stimulation (slows HR)
Where does a NG tube go
Nose to stomach
What is a NG tube used for
Used for suction or feeding & meds
Measurement for a NG tube
Nose to earlobe to xiphoid process
When inserting a NG tube and client feels tube at back of throat what should you have them do?
Swallow
Where should a NG tube enter? Where should it not enter? Why?
Should enter esophagus,not the lungs. This is because epiglottis is closed
Indications that a NG tube is in lung
Respiratory distress
Coughing
What should you do with a accidental respiratory NG tube placement?
Take out and start over
When must you verify NG tube placement
Initial placement and then before any feeding or meds
How should you verify initial NG tube at the bedside
1 assess the patients respiratory response
*causes gagging and discomfort, NOT coughing
#2 assessment of gastric contents
*pull back and see what is there
What color is normal fluid when aspirating
Stomach: ?
Lungs: ?
Stomach : grassy green, off-white, tan, clear; may have undigested food particles or formula
Lungs: clear or slightly tan, like mucus
How to use pH to confirm NG tube placement
Stomach: pH of 0-4 or 5
Lungs: pH 6 or higher
*problem with this is locating pH paper
What is only absolute placement verification
X-Ray
Upper abdomen/KUB
When securing a NG tube what should you do
- Tape carefully, without tension on nares
- mark the level of the tube at the nose with a permanent marker & measure external portion
When is a NG suction used
When GI tract is not functioning
What should you attach NG suction to? Why?
Attach to low intermittent suction it causes less trauma to stomach and mucosal lining
What is a Blue “pigtail” on Salem sump used for
Used for NOTHING
it’s function is a air vent that allows air exchange which reduces the pressure of auctioning on stomach lining
What is a NI tube? Where is it placed?
Nasointestinal tube
The end of the tube is weighted with mercury
Placement into stomach
Why is a NI tube secured
What position should pt be in?
How long does it take?
Secured so that peristalsis can carry it past sphincter into intestine
24-48 hrs, position on right side, semi-Fowlers
What must a patient have to use enteral (tube) feedings
Functional GI tract
What is preferred IV or tube feedings?
Tube feedings
What are two choices for tube feedings
Stomach or intestinal
Which type of tube feeding can only be given as a continuous drip
Intestinal
Which type of tube feeding is more natural
Stomach
What should you do when checking residual of a stomach tube feeding
If > 50% of last feed, return residual and hold feeding. Call dr for order
Is there residual with intestinal tube feeding
No residual
What can be used for long term feeding
Gastrostomy (G-tube)
At what speed should you give a tube feeding
Give SLOWLY
no faster than you would drink
How often should you change bag and tubing of a feeding tube
Every 24 hours
What is a Flexi-seal system
Indwelling system used to manage fecal incontinence; liquid stool; when full replace the bag
