pod 3

Question 1

what is nasogastric tube

Answer 1

inserted through one nostril, down nasopharynx, down esophagus into stomach

Question 2

large bore tube

Answer 2

salem sump tubing for gastric decompression and medications

Question 3

small bore tube

Answer 3

nasoenteric tube for feeding and medications

Question 4

how do you determine length of tube for insertion

Answer 4

tip in nostril, measure to ear, ear down to xiphoid process

Question 5

how can we determine correct tube placement

Answer 5

aspirate to gather gastric fluid

Question 6

pH of liquid

Answer 6

1-5.5

Question 7

what is likely if the fluid is greater than 6 pH

Answer 7

tracheal-bronchial tree

Question 8

ongoing care and management

Answer 8

• pH check
• external measurement check
• inspection of nostrils (discharge, irritation, adhesive tape on)
• resp assessment
• abdominal assessment
• mouth care
• connection to suction

Question 9

nasoenteric tubes for enteric feeds

Answer 9

• duodenum placement to reduce aspiration risk

Question 10

how do you verify placement for nasoenteric tubes?

Answer 10

XRAY

Question 11

for nasoenteric, what position should the patient be in

Answer 11

30-45 degrees

Question 12

complications of enteric feeds

Answer 12

• tube displacement
• tube occlusion
• abdo cramping, nausea, vomiting
• diarrhea
• pulmonary aspiration

Question 13

flushing meds through tube

Answer 13

• 30 cc before meds
• mix each med with 15-30 cc
• flush in between with 15-30 cc (10 cc for fluid restriction)

Question 14

tips for flushing meds through tube

Answer 14

• use warm water to mix for difficult to dilute meds
• use liquid meds
• crush finely!!
• flush well in between and after

Question 15

feeding solution types

Answer 15

• open
• closed

Question 16

open feeding system

Answer 16

pour solution into bag and prime tubing

Question 17

closed feeding system

Answer 17

comes prepared so you can spike bag with tubing

Question 18

gastrojejunum tubes

Answer 18

• long term use
• surgically inserted
• no risk for aspiration due to placement (jejunum)

Question 19

what equipment needed for nasogastric tube insertion

Answer 19

• NG tube (12-14fr)
• water soluble lubricant
• adhesive tape
• statlock stabilization device
• glass of water + straw
• 50mL syringe
• pH test strip
• suction set up
• marker

Question 20

how do you determine which nostril

Answer 20

• close either one, determine which has the best airflow and least amount of skin breakdown

Question 21

where do you aim when insertin

Answer 21

towards the ear

Question 22

pt gags?

Answer 22

• stop
• allow rest, take few breaths & sips of water
• advance with each swallow

Question 23

documentation for NG tube

Answer 23

• date & time insertion
• location of tube insertion (L/R nostril)
• type of tube
• size of tube
• means by which correct placement has been determined (pH reading, CXR)
• type of suction
• colour, amount, and other characteristics of gastric contents
• pt tolerance