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MATERNAL AND CHILD NURSING (2ND SEMESTER) > Laboratory 01: Orogastric Tube Insertion > Flashcards

Laboratory 01: Orogastric Tube Insertion Flashcards

1
Q

This is known as the process of inserting a rubber, plastic or silicone tube through the nose or mouth into the stomach.

A

Orogastric Tube (OGT) Insertion

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2
Q

Explain the phenomenon of Orogastric Tube (OGT) Insertion.

A

Liquid Food is instilled directly into the stomach or small intestine

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3
Q

What structures form the mouth?

A

The mouth is formed by the cheeks, the hard and the soft palate, and the tongue.

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4
Q

What is the primary function of the mouth in digestion?

A

The mouth is used to mechanically break food products into smaller portions.

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5
Q

What role does saliva play in the mouth?

A

Saliva lubricates and softens the food mass.

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6
Q

What enzyme is found in saliva, and what does it do?

A

Saliva contains the enzyme ptyalin (amylase), which breaks down starches to maltose.

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7
Q

How does the mouth assist in swallowing?

A

The mouth facilitates deglutition, or swallowing, of the bolus (food in the mouth).

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8
Q

This is a hollow muscular tube that extends vertically, connecting the hypopharynx to the stomach.

A

Esophagus

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9
Q

What are the functions of the esophagus?

A

(A) It serves as a passage for food from the mouth to the stomach.
(B) It propels the bolus into the stomach when the lower esophageal sphincter (LES) is open.

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10
Q

This provides a physiologic barrier to protect the esophageal mucosa from the effects of gastric influx (backflow of gastric secretions).

A

Lower Esophageal Sphincter (LES)

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11
Q

What occurs at the lower esophageal sphincter?

A

Peristaltic waves occur at the LES, either as an involuntary reflex of the glossopharyngeal nerve or with the dilation of the lower half of the esophagus.

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12
Q

This is a bean-shaped structure located in the upper portion of the abdomen.

A

Stomach

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13
Q

What are the three parts of the stomach?

A

(A) Fundus
(B) Body
(C) Pyloric Region

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14
Q

What are the four (4) layers of the stomach?

A

(A) Stomach
(B) Muscularis
(C) Submucosa
(D) Mucosa

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15
Q

What are the main functions of the stomach?

A

The stomach serves as:

(A) Storage of food.
(B) Mixing and liquefaction of the bolus into chyme.
(C) Control of food passage into the duodenum.

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16
Q

What gastric juices are secreted by the epithelial cells of the stomach?

A

(A) Hydrochloric Acid (HCl)
(B) Pepsin
(C) Gastrin

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17
Q

This gastric juices are secreted by the epithelial cells of the stomach breaks down proteins into polypeptides, proteases, and peptones.

A

Pepsin

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18
Q

This gastric juices are secreted by the epithelial cells of the stomach stimulates the secretion of HCl.

A

Gastrin

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19
Q

How long is the small intestine?

A

22 ft long

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20
Q

What are the three (3) parts of the small intestine?

A

(A) Duodenum
(B) Jejunum
(C) lleum

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21
Q

The small intestine is lined with what?

A

Villi which are fingerlike projections that is the primary absorption site for nutrients.

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22
Q

This extends from the ileocecal valve to the anus and is divided into three segments: cecum, colon, rectum, and anus.

A

Large Intestine

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23
Q

This comprises the first 2-3 inches of the large intestine and is where the appendix is located.

A

Cecum

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24
Q

What are the sections of the colon?

A

The colon is divided into four sections: ascending, transverse, descending, and sigmoid.

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25
Q

What are the functions of the large intestine?

A

(A) Absorb remaining water, urea, and electrolytes (e.g., sodium).
(B) Secrete mucus in the proximal half.
(C) Store feces in the distal half.
(D) Facilitate defecation.

26
Q

What is the role of the rectum and anus?

A

The rectum and anus serve as storage for feces before defecation.

27
Q

What are the primary functions of the large intestines?

A

(A) Complete absorption of water, chloride, and sodium.
(B) Reduce the volume of chyme.
(C) Manufacture vitamins, including some B vitamins and vitamin K.
(D) Form feces.
(E) Expel feces from the body.

28
Q

This is the mechanical breakdown from chewing, churning, and mixing with fluid, and chemical reactions in which food is reduced to its simplest form.

A

Digestion

29
Q

How does the body absorb nutrients?

A

The body absorbs nutrients through:
(A) Passive diffusion.
(B) Osmosis.
(C) Active transport.
(D) Pinocytosis.

30
Q

What is metabolism and storage of nutrients?

A

Metabolism and storage of nutrients involve biochemical reactions within the cells of the body.

31
Q

This involves chyme moving by peristaltic action through the ileocecal valve into the large intestine, where it becomes feces.

A

Elimination

32
Q

What is the purpose of orogastric tube insertion?

A

(A) Remove gastric contents
(B) Obtain specimen for laboratory examination
(C) Decompress the stomach of fluids or gas in paralytic ileus or abdominal

(D) Surgeries
(E) Cleanse the stomach of poisons or any irritating substance
(F) Determine the degree of pyloric
obstruction

(E) Lavage the stomach with ice water in cases of gastric bleeding
(F) Administer tube feedings and medications to clients unable to eat by mouth or swallow
(G) Establish a means for suctioning stomach contents to prevent distention, nausea and vomiting

33
Q

What are the contraindications of orogastic tube insertion?

A

(A) Peritonitis
(B) Intestinal Obstruction
(C) Intractable Vomiting
(D) Severe Diarrhea

34
Q

Which patients are at risk of feeding difficulties?

A

Patients who are:
(A) Semi-conscious or unconscious.
(B) Very weak.
(C) Operated on the mouth, tongue, or jaw.
(D) Having swallowing problems.
(E) Severely anorexic.
(F) Suffering from neurologic or psychiatric conditions.

35
Q

This is an alternative feeding method to ensure adequate nutrition through the gastrointestinal system.

A

Enteral Feeding

36
Q

What is another term for enteral feeding?

A

Enteral feeding is also referred to as total enteral nutrition.

37
Q

What is a common complication of enteral tube feeding and its intervention for pulmonary aspiration?

A

Pulmonary aspiration - Verify tube placement.

38
Q

What is a common complication of enteral tube feeding and its intervention for diarrhea?

A

Diarrhea - Use aseptic technique.

39
Q

What is a common complication of enteral tube feeding and its intervention for constipation?

A

Constipation - Consult dietician, add water during tube flushes, and encourage the patient to ambulate if possible.

40
Q

What is a common complication of enteral tube feeding and its intervention for tube occlusion?

A

Tube occlusion - Irrigate the tube before and after giving medications.

41
Q

What is a common complication of enteral tube feeding and its intervention for tube displacement?

A

Tube displacement - Check tube placement and secure the tube properly

42
Q

What is a common complication of enteral tube feeding and its intervention for abdominal cramping/Nausea/Vomiting (N/V)?

A

Abdominal cramping/Nausea/Vomiting (N/V) - Warm the formula and slow the feeding.

43
Q

What is a common complication of enteral tube feeding and its intervention for delayed gastric emptying?

A

Delayed gastric emptying - Administer medication for gastric motility and assess for possible other GI problems.

44
Q

What is a common complication of enteral tube feeding and its intervention for serum electrolyte imbalance?

A

Serum electrolyte imbalance - Monitor serum electrolytes.

45
Q

What is a common complication of enteral tube feeding and its intervention for fluid overload?

A

Fluid overload - Monitor intake and output (I&O), restrict fluid as needed.

46
Q

What is a common complication of enteral tube feeding and its intervention for hyperosmolar dehydration?

A

Hyperosmolar dehydration - Slow the rate of delivery, dilute or change to isotonic formula.

47
Q

What does ADRI stand for and how is it related to enteral tube feeding?

A

ADRI (Adverse Device-Related Injury) - Perform assessment and precautionary measures to avoid injuries related to medical devices.

48
Q

How can feeding tube-related issues be prevented?

A

One way to prevent issues with feeding tubes is by properly taping the tube to ensure it remains in place.

49
Q

What are the types of feeding tubes?

A

(A) Plastic - For short-term use.
(B) Silicone - For use over several months.
(C) Rubber - Used for varying durations, typically less common than plastic and silicone.

50
Q

What are the typical sizes of feeding tubes for NG tube feeding based on age groups?

A

(A) Neonates: 6fr to 8fr
(B) Infants to 5 years: 8fr to 10fr
(C) Over 5 years: 8fr to 14fr

51
Q

Why is tube calibration important?

A

Ideally, the tube should have calibration markings to ensure accurate placement and measurement.

52
Q

Where is the ideal placement of the feeding tube marked?

A

The feeding tube’s ideal placement is typically measured from the nose to the earlobe.

53
Q

What are some common nursing diagnoses related to feeding tubes?

A

(A) Impaired swallowing
(B) Impaired low nutritional intake
(C) Risk for aspiration
(D) Risk for infection
(E) Pain
(F) Impaired skin integrity

54
Q

What is an important action regarding tube placement?

A

Reassess tube placement regularly to ensure it is correctly positioned.

55
Q

What are the materials needed?

A

(A) NGT/OGT Tube Fr.8
(B) Water Soluble Lubricant
(C) Feeding Equipment, 60 cc Asepto
(D) Syringe or Feeding Bag
(E) Normal Saline Irrigation Solution
(F) Sterile Gloves
(G) Emesis Basin
(H) Hypoallergenic Tape
(I) Tow

56
Q

What are the steps in preparing for enteral tube insertion?

A

(A) Check physician’s order.
(B) Wash hands prior to procedure.
(C) Don gloves.
(D) Provide privacy.
(E) Raise side rails.
(F) Adjust room temperature and lighting.
(G) Gather all equipment.

57
Q

What assessments are necessary before inserting the enteral tube?

A

(A) Check physician’s order.
(B) Wash hands prior to procedure.
(C) Don gloves.
(E) Provide privacy.
(F) Raise side rails.
(G) Adjust room temperature and lighting.
(I) Gather all equipment.

58
Q

What assessments are necessary before inserting the enteral tube?

A

(A) Inspect oral mucosa for irritation.
(B) Change adhesive as required to prevent skin irritation.
(C) Assess client’s condition and need for OGT (orogastric tube).
(D) Assess overall status:
1. Weight change/loss
2. Temperature
3. Presence of sepsis
4. Trauma
5. Mental status
6. Other medically related nutritional problems

(E) Evaluate fluid intake.
(F) Assess nutritional requirements, GI tract status, and capacity to chew and swallow.
(G) Check for the presence of gag reflex.
(H) Evaluate thoracic or respiratory conditions.
(I) Check renal complications.
(J) Assess fluid and electrolyte imbalances.

(K) Assess GI system:
1. Check for obstruction
2. Auscultate bowel sounds
3. Palpate abdominal distention.

59
Q

What nursing diagnoses should be developed?

A

(A) Altered nutrition, less than body requirements.
(B) Impaired swallowing.

60
Q

What is the implementation procedure for enteral tube insertion?

A

(A) Explain the procedure to the client.
(B) Raise the bed to high Fowler’s position, cover chest with towel, and place emesis basin nearby.
(C) Measure the length of tubing to be inserted:
(From the tip of the nose to the tip of the earlobe and from the tip of the earlobe to the tip of the xiphoid process).

(E) Mark the tubing after assessing length.
(F) Lubricate the tip of the tube with water-soluble lubricant (avoid oil-based).
(G) Hyperextend the neck of the client.
(H) Gently insert the tube into the mouth and advance it into the posterior pharynx.

(I) Advance the tube as the client swallows.
(J) Assess placement:
(K) Inject 10ml of air and auscultate over the epigastric area (bubbling indicates stomach placement).

(L) Check gastric content characteristics (yellow-green color).
(M) Check acidity of aspirated contents (gastric aspirates should be acidic, pH of 4-6).

(N) Small intestine aspirate has pH ≥ 6, respiratory secretions > 7.
(O) Check for dislodgement if patient experiences coughing, sneezing, or vomiting.

(P) Clean the mouth with cotton balls to remove excess oil.
(Q) Secure the tube with tape on the client’s cheek.
(R) Teach the client how to perform oral care.
(S) Dispose of materials properly.
(T) Remove gloves and perform handwashing.

MATERNAL AND CHILD NURSING (2ND SEMESTER) (6 decks)

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