nasogastric tube

Question 1

nasogastric tubes

Answer 1

a pliable tube that is inserted into the paitnets stomach

has a hollow lumen that allows for removal of gastric secretions and introduction of soloutions into the stomache

small or large bore

Question 2

use of ngt tubes

Answer 2

enteral feeding 
admin medications
suctioning 
lab analysis
lavage
internal application of press

Question 3

indications for ngt tubes

Answer 3

post op
impaired peristalsis
abdominal distention
critical illness

Question 4

client assessment

Answer 4

patency of nares and intactness of nasal tissues
gag reflex
level of conciseness
auscultate abdomen

Question 5

maintenance of ng tubes

Answer 5

irrigate tube as required 
verify placement 
maintain patency 
 asesses abdomnial
auscultate bowel sounds/breath sounds

Question 6

care of client

Answer 6

maintaining comfort 
assess nares and muscossa
freq lubricate nares
freq mouth care
freq mouth/asess abdominal respiratory

Question 7

complications

Answer 7

abdominal distention, vomiting 
absence of drainage 
throat irritation
chronic inflammation
erosion of the nares and nasal muscossa 
fluid volume deficit 
pulm aspiration

Question 8

Aspiration immediate

Answer 8

Coughing
Dyspenea
Cyanosis 
Crackels and wheezes
Decreased o2 says
Increased RR

Question 9

Delayed response

Answer 9

Fever

Development of phenomia

Question 10

Unexpected outcomes with enteral feeds

Answer 10

Increased gastric residual (more than 200-500) 
Diahrea 
N/V
Clogged tubes/ fluid overload
Dehydration

Question 11

Guidelines for dietary change

Answer 11

advocate reduced saturated and trans fats, reduced sodium, and reduced refined sugars, as well as an increased intake of complex carbohydrates and fibre.

Question 12

Importance balanced diet

Answer 12

carbohydrates, fats, proteins, vitamins, and minerals provides the essential nutrients to carry out the body’s normal physiological functioning

Question 13

Lipid emulsions

Answer 13

provide supplemental kilocalories and prevent deficiencies of essential fatty acids.

These emulsions can be administered through a separate peripheral catheter, through the CVC by Y-connector tubing

Question 14

Contraindications to giving lipids

Answer 14

are hyperlipidemia, lipid nephrosis, severe liver failure, and egg allergy.

Question 15

Who benefits from parental feeding

Answer 15

Patients who are unable to digest or absorb enteral nutrition benefit from parenteral nutrition.

Patients in highly stressed physiological states, such as sepsis, head injury, or burns, are also candidates for parenteral nutrition therapy

Question 16

Enteral nutrition

Answer 16

refers to nutrients given via the gastrointestinal tract

Question 17

where can you insert a gt tube

Answer 17

(nasogastric-orogastric or
nasointestinal-orointestinal tubes),
surgically through a stoma
jejunum (gastrostomy or jejunostomy tubes)
endoscopically (percutaneous endoscopic gastrostomy
jejunostomy

Question 18

large bore sump tubing

Answer 18

large bore sump tube is most used for stomache decompression and short term feeding

Question 19

small bore tubing

Answer 19

small-bore, silastic tubing with insertion stylet is used for longer-term feeding needs.

The small-bore nasogastric or nasojejunal tube is preferred over large-bore tubes as they reduce patient discomfort and gastric erosion

Question 20

when a nasal feeding tube used

Answer 20

less than 4 weeks, nasoenteral tubes may be used.

Question 21

surgical placed feeding tube

Answer 21

Surgical or endoscopically placed tubes are preferred for long-term feeding (>4 weeks) to reduce the discomfort of a nasal tube and to provide a more secure, reliable access

Question 22

Indications for Enteral Nutrition

Answer 22

Cancer (Head and neck Upper gastrointestinal tract)
Critical Illness or Trauma
Neurological and Muscular Disorders
Gastrointestinal Disorders

Question 23

BMR

Answer 23

basic metabolic rate

This is the energy needed to maintain life-sustaining activities (breathing, circulation, heart rate, and temperature) for a specific period of time.

Question 24

REE

Answer 24

resting energy expenditure (REE) is a measurement that accounts for BMR plus energy to digest meals and perform mild activity.

REE is a baseline of energy requirement accounting for approximately 60% to 75% of our daily needs.

Question 25

risk of aspiration

Answer 25

Patients with gastroparesis 
(decreased or absent innervation) 
esophageal reflux, 
those at risk for aspiration, 
those with a history of aspiration pneumonia

Question 26

when inserting a feed tube with person who is unconsciousness

Answer 26

or who are intubated and sedated, may also have impaired gag reflex, and their risk of aspiration

For patients who are intubated, sedated, or too ill to participate in the procedure, ensure that the patient’s head is tilted toward the chest for enteral feeding tube insertion.

Question 27

alert patient inserted into patient

Answer 27

Encourage a patient who is alert and communicating to swallow by giving small sips of water or ice chips when possible.

Advance tube as patient swallows or as patient’s head is tilted toward chest. Rotate tube 180 degrees while inserting.

Question 28

nutrition guidelines for enteral feeding

Answer 28

Nutrition guideline recommends a range of 250 to 500 mL
Volumes greater than 200 are considered high in critically ill
if residual volume exceeds 500 mL, feedings may be withheld.

Question 29

Polymeric formulas

Answer 29

(1.0 to 2.0 kcal/mL) include milk-based blenderized foods prepared by hospital dietary staff or in the patient’s home.

Question 30

Modular formulas

Answer 30

(3.8 to 4.0 kcal/mL) are single-macronutrient (e.g., protein, glucose, polymers, or lipids) preparations and are not nutritionally complete

Question 31

specialty formulas

Answer 31

(1.0 to 2.0 kcal/mL) are designed to meet specific nutritional needs in certain illnesses (e.g., liver failure, pulmonary disease, or human immunodeficiency virus [HIV] infection).

Question 32

refeeding syndrome

Answer 32

(metabolic disturbances that occur as a result of reinstituting nutrition) because cations such as potassium, magnesium, and phosphate move intracellularly