Seminar 5 Enteral feeding

Question 1

what is the definition of enteral nutrition

Answer 1

the administration of nutrients into the GI tract

Question 2

what is one blood test result that would be elevated during malnutrition

Answer 2

usually liver enzymes will be increased (since the liver is being damaged)

Question 3

what is the definition of parenteral feeding

Answer 3

administrating nutrients via an IV through a central vein

Question 4

what are two contraindications for enteral feeding

Answer 4

-if the patient doesn’t have a gag reflex (because they have to be able to protect their airway
-if they can not elevate the head of their bed

Question 5

how must an enteral feed be administered to prevent refeeding syndrome

Answer 5

Feeds should be started slow and electrolytes should be monitored carefully

Question 6

how long after a feed is stopped should you keep the head of the bed elevated

Answer 6

keep the head of the bed elevated for at least 1 hour

Question 7

what 3 factors increase the risk of aspiration for a person with a feeding tube

Answer 7

-HOB less than 30 degrees
-Age over 60
-Delayed gastric emptying

Question 8

what would be an immediate treatment for aspiration

Answer 8

stop feed
lower head of bed
lay client on left side (to prevent further seepage of formula into lungs)

Question 9

what is an example of a har bore/large bore NG tube

Answer 9

salem sump tube

Question 10

is a salem sump a single or double lumen NG tube

Answer 10

it is a double lumen NG tube

Question 11

what is an example of a soft bore NG tube

Answer 11

Levin NG tube

Question 12

what kind of NG tubes have a stylet and what is it

Answer 12

Small bore feeding tubes have a stylet which is a metal wire that keeps the tube rigid during insertion

Question 13

how often do small bore feeding tubes need to be changed

Answer 13

need to be changed monthly

Question 14

what kind of feeding tube would be used for short term feeds

Answer 14

Nasogastric tube

Question 15

What is the timeframe of a short term feed

Answer 15

less than 4-6 weeks

Question 16

when would a nasoduodenal or nasojejunal tube be indicated

Answer 16

if the client is at a high risk for aspiration

Question 17

what types of feeding tubes would be used for longer term feeds

Answer 17

Gastrostomy or jejunostomy tubes

Question 18

what amount of time qualifies as a long term feed

Answer 18

if the patient will require feeding for more than 6-8 weeks

Question 19

what is the difference between a G tube and a PEG tube

Answer 19

a G tube is placed laparoscopically and a PEG tube is placed with an endoscope
-PEG tube also has a smaller incision

Question 20

What does PEG tube stand for

Answer 20

Percutaneous Endoscopic Gastrostomy Tube

Question 21

how long after insertion of a gastric or jejunal tube do you have to wait to check the balloon volume

Answer 21

check balloon volume after 4 weeks

Question 22

4 weeks after the insertion of a G tube or J tube how often do you have to check balloon volume

Answer 22

after 4 weeks check the balloon volume weekly

Question 23

what kind of syringe do you use while checking the volume of a balloon on a G or J tube

Answer 23

use a slip tip syringe not a leur lock because it avoid damage

Question 24

If a feeding tube was accidently pulled out what would you do

Answer 24

DO NOT try to reinsert and call MRP

Question 25

what type of feeding system is initially used when a client can not tolerate a bollus feed

Answer 25

closed/continuous drip system

Question 26

how long is the hang time for a continuous feed bag

Answer 26

up to 48 hours if sterile technique was used

Question 27

how often does the bag and the tubing need to be replaced in a continuous feeding system

Answer 27

every 48 hours

Question 28

how many mL is usually given in a bolus feed

Answer 28

usually 300-500 mL

Question 29

how long are bolus feed usually administered for

Answer 29

usually administered over 30 min

Question 30

what do all feeding systems need to be labeled with

Answer 30

Client info Date Nurses initials type of formula rate strength amount

Question 31

what is the hang time on a tetra pack

Answer 31

8 hours

Question 32

what is the hangtime for reconstructed powder formula

Answer 32

4 hours

Question 33

how often does the bag and tubing need to be replaced in an open system feed

Answer 33

every 24 hours

Question 34

how often do attachments like stopcocks or valves need to be replaced on feeding systems

Answer 34

weekly

Question 35

What three things are required prior to initiating a feed

Answer 35

-doctors orders -X ray confirming tube placement -documentation in the clients chart from the MRP confirming the tubes placement

Question 36

what is total free water requirement

Answer 36

amount of fluid a client needs in a 24 hour period to sustain life

Question 37

if someone was not at risk for refeeding syndrome what rate would their feed be started at

Answer 37

25 mL/h for 8 hours than can start to increase

Question 38

if someone was at risk for refeeding syndrome what rate would their feed be started at

Answer 38

25 mL/h for 24 hours than it could be increased

Question 39

if someone was not at risk for refeeding syndrome how much could you increase their feed by after 8 hours

Answer 39

can increase by 50 mL/h until desired rate is reached

Question 40

what is the most accurate way to confirm the placement of a NG tube

Answer 40

chest X ray

Question 41

if a pt was on a continuous feed how often do you flush and with how much water

Answer 41

flush every 4 hours with 50 mL of water

Question 42

how often do you flush a feeding tube if it is not in use

Answer 42

flush twice a day when not in use

Question 43

when would you flush the tube with sterile water instead of just tap water

Answer 43

if the client is immunocompromised

Question 44

how much water do you flush with before medication administration

Answer 44

flush with 30 mL

Question 45

how much water do you flush with after a medication administration

Answer 45

30 mL

Question 46

how often do you rotate a gastrostomy tube

Answer 46

daily

Question 47

what type of tube should never be rotated

Answer 47

J-tubes since it increases the risk for twisting and maybe blockage

Question 48

how much water do you flush with between medication administrations

Answer 48

15 mL