Nasogastric Tubes

Question 1

Nasogastric tube

Answer 1

Pliable

Nasopharynx –> stomach

Removal of gastric secretions and introduction of solutions into stomach

Small or large bore

Question 2

Uses of NGT

Answer 2

Enteral feed

Meds

Suctioning

Lab analysis

Internal pressure

Question 3

Why may someone have a NGT

Answer 3

Post-op

Impaired peristalsis

abdominal distention

Critically illness

Question 4

Client Assessment

Answer 4

Patency of nares

Gag reflex

LOC

Auscultate abodomen

Question 5

If gastric residual is more than 200-500ml

Answer 5

Withhold feed, notify, semi-fowlers

Question 6

N/V

Answer 6

Check patency, aspirate, auscultate

Question 7

How to position pt for insertion

Answer 7

High fowlers

Place pillow behind pts head/shoulders

Question 8

After tube passes through nasopharynx..

Answer 8

Tilt head forward to prevent opening of epiglottis

Question 9

How to verify placemenr

Answer 9

Test pH, less than or equal to 5

Must be verified by xray before initiated

Question 10

Why is it important to ensure placement before initiation?

Answer 10

To prevent aspiration pneumonia

Question 11

pH of Intestinal fluid

Answer 11

less than/ equal to 6

Question 12

pH of respiratory fluid

Answer 12

greater than 6

Question 13

Why clamp tube before removal?

Answer 13

So it does not leak

Question 14

If bowel sounds absent

Answer 14

Indicate absence of peristalsis, increase risk of aspiration/distention

Question 15

Used for how long?

Answer 15

Less than 4 weeks

Question 16

Indication for beyond the stomach

Answer 16

Gastroparesis, esophageal reflux, aspiration, asp. pneumonia

Question 17

Normal gastric residual

Answer 17

250-500ml Indicates whether gastric emptying is delayed

Question 18

do not hang formula longer than

Answer 18

4hr

Question 19

Change bag/tubing every

Answer 19

24hr

Question 20

Large bore

Answer 20

Decompression

short term

Question 21

Small bore

Answer 21

Longer term

Question 22

When is a small tube inserted?

Answer 22

after 24-48 hrs, if large bore was tolerated

Question 23

When are surgical/endoscopically placed tubes inserted?

Answer 23

When enteral nutrition is needed for more than 4 weeks

Question 24

Polymeric formula

Answer 24

Milk based, blenderized foods

or commercially prepped nutrient-whole formulas

Whole gastrointestinal tract must be functioning

Question 25

Modular formula

Answer 25

Single-macronutrient

not nutritionally complete

Added to other foods for meeting individuals needs

Question 26

Elemental formula

Answer 26

Predigested nutrients that are easier for a dysfunctional GI tract to absorb

Question 27

Specialty formula

Answer 27

Designed to meet specific nutritional needs

Question 28

Refeeding syndrome

Answer 28

Metabolic disturbances that occur as a result of reinstitution of nutrition

Question 29

Parenteral nutrition

Answer 29

Specialized nutrition

Nutrients are provided intravenously

Central access

Question 30

When may someone require parenteral nutrition?

Answer 30

Pts unable to digest or absorb enteral nutrition

Highly stressed states

Question 31

Lipid emuslions

Answer 31

Parenteral

Prevent deficiencies of essential fatty acids

Can be separate or part of a mixture

Question 32

Lipid emulsion - what to look out for

Answer 32

Should not be used if oil droplets are observed on the surface

Lipid emboli

Question 33

Initiation of TPN

Answer 33

PICC

Verified by chest x-ray/radiographically

Flushed with salin/heparin

Question 34

If encountering resistance when placing a nasogastric tube…

Answer 34

withdraw the tube