WEEK 12 NG TUBES Flashcards
What are 4 uses for gastric intubation?
- Decompression
- Feeding/medication administration
- Washing out (lavage)
- Compression (stop bleeding)
What are contraindications for NG tubes?
- Esophageal varices
- Recent esophageal/gastric surgery
- Basilar skull fracture
What is the purpose of decompression?
Remove secretions from stomach to prevent distention as well as nausea/vomiting
What is the purpose of a single lumen (Levine) tube?
Drains gastric contents only
What is the purpose of a double lumen (Salem Sump) tube?
Drains gastric contents through one lumen and allows air into other lumen to prevent adherence to stomach wall
What is the purpose of tilting the head forward when advancing the NG tube?
Closes off the glottis
What are 4 signs that the NG tube is incorrectly placed?
- Coiling
- Coughing/gagging
- Diaphoresis
- Sinus pressure/headache
What is important to remember any time a patient with an NG tube coughs, sneezes, or vomits?
Reassess placement
When checking gastric aspirate, what pH reading is concerning for tube displacement?
6 or higher
What pH level is acceptable if patient is on antacids or H2 blockers?
5-6
Which lab values are important to monitor for patients with an NG tube?
Electrolytes
What are 4 important points to remember when administering medications to a patient with NG attached to suction?
- Check agency policy
- Stop suction and flush
- Administer meds as usual
- Leave suction off for 30 mins to ensure absorption
How should an NG tube be removed?
Quickly on exhalation
Which kinds of enteral feeding tubes are placed in Radiology?
- Nasoduodenal
- Nasojejunal
- Gastrostomy
- Jejunostomy
What kind of enteral feeding tubes are placed in OR?
Gastrostomy and jejunostomy
How long may a Salem Sump tube be used for enteral feeding?
0-4 weeks
How long may an Entriflex NG tube be used for enteral feeding?
4-8 weeks
What are 3 reasons we place tubes beyond the stomach?
- Gastroparesis
- GERD
- Aspiration risk (including history of aspiration/pneumonia)
What are 2 ways Entriflex tubes differ from Salem Sump?
- Smaller: 8-12 Fr
- Guide wire
What are 4 indications for enteral feeds?
- Altered LOC
- Delayed gastric emptying
- Need for additional nutritional support
- Mechanical swallowing deficit
What are 4 points to remember with open feeding systems?
- Only add 4 hrs supply to bag at a time
- Keep the opened formula in the fridge
- Discard opened formula in 24 hrs
- Replace the bag and tubing set every 24 hrs
After connection to tubing for feeding, how long can a closed system bag and tubing set be kept at room temperature for?
24-48 hrs
What are 6 assessment findings that indicate tolerance of enteral feeds?
- Normoglycemia
- Normal bowel habits
- Normal abdominal girth
- Healthy weight
- Normal electrolytes
- Balanced ins/outs
How are residural feeds assessed?
- Attach syringe to tube and withdraw until resistance
- Re-feed back
- Hold feed if more than 200 ml (or more than 10-20% of hourly rate)
- Re-check in 3-4 hrs
What is the response if a PEG tube becomes dislodged?
- Stop feeds
- Cover, or if in an established tract, insert a foley or red rubber catheter to maintain passage
- Notify physician
What is the response if there is a suspected aspiration?
- Stop feeds
- Give O2 as needed
- Suction as needed
- Take vital signs
- Call physician
