W/S 7

Question 1

What is a nasogastric tube?

Answer 1

nasogastric feeding tube is inserted via the nose and exits in the stomach

Question 2

What is a nasoduodenal tube?

Answer 2

nasoduodenal feeding tube is inserted via the nose but is allowed to pass into the duodenum, usually with assistance, either endoscopic or radiological.

this is used to overcome the problems associated with gastric stasis

it is also referred to as ‘post pyloric’.

Question 3

What is a nasojejunal tube?

Answer 3

nasojejunal tubes are usually inserted endoscopically or radiologically to ensure that they are in the correct position in the jejunum.

if being used to minimise pancreatic stimulation, the tube is passed beyond the hepatic flexure (ligament of Trietz).

Question 4

What is percutaneous gastronomy?

Answer 4

percutaneous gastrostomy tubes are inserted into the stomach via the abdominal wall, most commonly endoscopically
- percutaneous endoscopic gastrostomy, PEG

a permanent tract (stoma) forms after 3 weeks

the device is held in place with an internal balloon or bumper and an external fixator.

Question 5

What is percutaneous jejunostomy?

Answer 5

percutaneous jejunostomy tube is inserted into the jejunum via the abdominal wall, endoscopically (PEJ), radiologically or surgically

they are held in place either externally with stitches or internally with a flange or Dacron cuff.

Question 6

What is percutaneous gastrojejunostomy?

Answer 6

percutaneous gastrojejunostomy tube is inserted into the stomach via the abdominal wall and the exit of the feeding tube is placed into the jejunum, most commonly endoscopically (PEGJ)

this can be done as the primary procedure, or a tube can be placed into the jejunum via an existing PEG tube

Question 7

Why might blockage of enteral feeding tubes occur?

Answer 7

small internal diameters of the tubes

inappropriately prepared medications

poor flushing technique or poor attention to the flushing regimen prescribed
- gastric acid, feed, and medication interactions.

bacterial colonisation within the feeding tube

Question 8

What non-drug measures can be used to prevent delirium in patients in intensive care? What are the long terms effects of delirium?

Answer 8

sedation breaks and use short acting sedatives
avoid benzodiazepines and anticholinergics
sleep hygiene - reduce noise

long term cognitive decline, risk of developing dementia and brain structure changes

Question 9

What is the mechanism of dexmedetomidine? What is it used for?

Answer 9

is a specific and selective alpha-2 adrenoceptor agonist

sedation