Week 1 NG tubes and drains

Question 1

what are the typical sizes for NG tubes for pediatric and adult patients

Answer 1

Pediatric: 5-12 french
Adults: 12-18 french

Question 2

what are contraindications for an NG tube

Answer 2

-Head, neck or throat trauma
-absence of a gag reflex (patients should be able to protect their airway

Question 3

what is the purpose of the vent lumen on a large bore NG tube

Answer 3

allows for inflow of air which prevents a vacuum if the tube adheres to the stomach wall which decreased tissue damage

Question 4

what is the main difference between a hard bore and soft bore NG tube

Answer 4

-the size
-Hard bore is double lumen

Question 5

what is the typical size for a soft bore NG tube

Answer 5

6-12 fr

Question 6

how often are soft bore NG tubes changed

Answer 6

Q-monthly

Question 7

what causes re-feeding syndrome

Answer 7

someone has been starving and is suddenly fed this influx of carbs causes a massive spike in insulin which also shifts electrolytes into cells and out of blood
-it also causes an increase in o2 demand and the body may not be able to keep up

Question 8

what factors increase the risk for aspiration in a patient that has an NG tube

Answer 8

-HOB less than 30 degrees
-decreased LOC
-poor oral health
-age over 60
-delayed gastric emptying

Question 9

Should a person with an NG tube swallow anything

Answer 9

not unless it is ordered

Question 10

how long after NG feeding should you elevate HOB

Answer 10

30-60 min

Question 11

what position should the patient be in while inserting an NG tube

Answer 11

High fowler’s

Question 12

how would a nurse measure out the correct length of NG tube that is going to be inserted

Answer 12

measure from the tip of the nose to the ear lobe and then down to the xiphoid process and add an extra 15 cm

Question 13

how should an unconscious patient be positioned for NG tube insertion

Answer 13

on their right side

Question 14

what is the procedure for removing an NG tube

Answer 14

-Flush tube with 50mL of water or air (to prevent contents of tube from going into lungs during removal)
-sit patient upright with head flexed slightly forward
-instruct patient to deep breath and hold (don’t cough)
-document

Question 15

what are the things you have to document after an NG tube insertion

Answer 15

-Type of tube inserted (ie large or soft bore)
-External length
-Type of securement
-Confirmation of placement preformed
-Suction rate/characteristic of output
-Type and rate of enteral feed
-Assessments performed
-how patient tolerated procedure

Question 16

how often do you verify the external length on an NG tube by measurement

Answer 16

once a shift

Question 17

how often do you visually assess external length of an NG tube

Answer 17

every 4 hours or before each use

Question 18

what are the two main reasons that drains are used during wound healing

Answer 18

-prevent infection
-remove fluid that would otherwise build up and delay wound healing

Question 19

what is the difference between a closed and open drainage system

Answer 19

open systems have no suction while closed systems do

Question 20

what is an example of an open drainage system

Answer 20

penrose drain

Question 21

what are examples of closed drainage systems

Answer 21

-Hemovac
-Jackson pratt

Question 22

what characteristics of wound drainage would you document

Answer 22

-amount
-color
-consistency
-odor

Question 23

when removing a drain and cleaning the incision and drain insertion site which do you clean first the incision or the drain insertion site

Answer 23

clean the incision site first and the the drain insertion site

Question 24

how long after removing a drain do you need to access the bandage to see if there is any shadowing

Answer 24

30 min after removal

Question 25

what information would you document after a penrose drain shortening and a wound assessment

Answer 25

-Characteristics of drainage
-wound care provided
-shortening length of penrose drain
-Type of dressing applied
-patients tolerance of procedure

Question 26

when would you flush a NG tube with air or water

Answer 26

30 min prior to removal