unit eight

Question 1

what are the 3 indications for enteral feeding?

Answer 1

1. normal eating is unsafe d/t high risk for aspiration
2. conditions interfering with normal ingestion/absorption, or create a hypermetabolic state
3. conditions where diseases/treatments reduce oral intake d/t symptoms

Question 2

what are the 4 enteral feeding delivery methods?

Answer 2

1. bolus: gastric feedings, for ambulatory patients, given like meals, syringe or gravity, infusion time up to 20 min
2. intermittent: gastric feedings, ambulatory patients, given at various times in 24 hours, by gravity or pump, over 20-60 min
3. continuous: for patients who can’t tolerate intermittent, given continuously, for critically ill patients, given by pump
4. cyclical: use in home care, given during day or overnight, a constant rate over 8-16 hours

Question 3

nursing responibilities for enteral feeds:

Answer 3

• inserting NG or OG tube
• verifying position
• keeping tube patent during flushing
• assessing tissue arounf tube, providing oral/nasal care
• administering nutrient formula/medications through tube
• keep pt NPO unless ordered otherwise
• preventing complications
• documenting, monitoring I+O

Question 4

what are the steps of enteral feeding?

Answer 4

1. assess: allergies, abdomen, weight, fluid volume status, serum electrolytes, blood glucose
2. confirm correct placement
3. verify order (type of formula, rate, route, frequency)
4. keep HOB 30-45 degrees
5. change tubing q24h or manufacturer’s standards
6. keep formula at room temperature
7. check gastric residual volume and flush with 30mL sterile water before bolus or intermittent feeds, or q4-6h during continuous
8. clean bag and tubing with water between feeds

Question 5

what 3 ways can you check placement of an NG tube?

Answer 5

1. x ray (best practice)
2. gastric pH (less than or equal to 5)
3. appearance and volume of aspirated fluid (green or brown)

Question 6

what are 5 complications from NG tubes?

Answer 6

1. discomfort
2. intubation into respiratory tract
3. migration of NG tube
4. tissue breakdown and pressure injuries
5. aspiration of gastric contents

Question 7

what are the different types of ostomies?

Answer 7

• colostomy (ascending, transverse, descending, sigmoid, loop)
• ileostomy
• ureterostomy

Question 8

what are you assessing during ostomy care?

Answer 8

• stoma: size shape, color, edema, bleeding, consistency and frequency of stool, production of flatus
• peristomal skin: healing, erythema, irritation, breakdown
• equipment and supplies recommended for patient: pouch, appliance, skin barrier
• patient’s knowledge and comfort working with the ostomy

Question 9

when should you change the pouch? when should you empty the pouch?

Answer 9

• change pouch q3-7 days
• empty pouch if more than 1/3 to 1/2 full
• remove flatus prn