GI tubes

Question 1

How often should a gastric pH be tested for NG tubes

Answer 1

every 4 hours for continuous feeding or before every feeding

Question 2

nursing considerations for Small-bore NG feeding tubes

Answer 2

1. obtain an x-ray to determine placement
2. Maintain Semi-fowler’s position while feeding is infusing
3. Assess residual in the stomach and refeed the residual unless it exceeds the maximum
4. provide nose and mouth care
5. replace tube every 4 weeks

Question 3

What should a nurse do if the residual exceeds 100mL for intermittent feedings or 2 hours of continuous feeding?

Answer 3

Hold or stop the feeding; DO NOT refeed aspirate; notify the provider

Question 4

Nursing Considerations for PEG

Answer 4

1. assess skin integrity
2. Assess residual volume
3. allow feeding to infuse slowly (raise/lower syringe)
4. flush with 30 mL warm water before and after feeding
5. Maintain semi-Fowler’s position 1-2 hours after feeding

Question 5

What is Parenteral Nutrition?

Answer 5

IV administration of a hypertonic IV solution made up of glucose, insulin, minerals, lipids, electrolytes, and other essential nutrients. Used when the client cannot effectively use the GI tract for nutrition

Question 6

PPN

Answer 6

1. Partial or Peripheral Parenteral Nutrition
2. Used when a client can eat, but cannot take in enough nutrients to meet needs
3. Administered through a large distal arm vein or PICC line (given “peripherally”)

Question 7

TPN

Answer 7

1. Total Parenteral Nutrition
2. Used when the client requires intensive nutritional support for an extended time period
3. Delivered through a Central vein

Question 8

What contributing factors could cause the need for parenteral nutrition?

Answer 8

1. GI mobility disorders
2. inability to achieve or maintain adequate nutrition for body requirements
3. Short bowel syndrome
4. Chronic pancreatitis
5. Severe burns
6. Malabsorption disorders

Question 9

Nursing interventions for parenteral nutrition

Answer 9

1. confirm placement by chest x-ray
2. monitor Central line insertion site for local infection
3. Maintain strict surgical asepsis for dressing change (every 72 hours)
4. Change tubing and remaining TPN every 24 hours
5. Monitor for signs of systemic infection
6. Monitor glucose, electrolytes, and fluid balance
7. prevent air embolism
8. use the infusion pump
9. keep 10% dextrose/water available
10. For clients receiving fat emulsions, monitor for fat overload syndrome

Question 10

What are the sx of fat overload syndrome?

Answer 10

1. fever
2. increased triglycerides
3. clotting problems
4. multisystem organ failure