Chapter 45 Digestion Quiz
A dressing over the tube outlet & the gastrostomy tube protects the skin around the incision from _____ & _____.
seepage of gastric acid, spillage of feeding
What is the Sengstaken-Blakemore tube used for?
Control of bleeding esophageal varices
A patient has had a gastrostomy tube inserted. What does the nurse anticipate the initial fluid nourishment will be after the insertion of the gastrostomy tube?
10% glucose & tap water
Why must extra caution be taken when inserting a feeding tube with a stylet?
Caution is required when inserting feeding tubes with a stylet because there is a risk of tissue puncture or placement error.
Triple-lumen nasogastric tube that also has a duodenal lumen for postoperative feedings
Moss tube
_____ or _____ feeding is indicated when the esophagus & stomach need to be bypassed or when the patient is at risk for aspiration.
Nasoduodenal, nasojejunal
A nasally placed feeding tube is for short term use & should stay in place for no more than _____ weeks before being replaced with a new tube.
4
The nurse inserts a nasogastric tube into the right nares of a patient. When testing the tube aspirate for pH to confirm placement, what does the nurse anticipate the pH will be if placement is in the lungs?
6
The nurse is caring for a patient who has dumping syndrome from high carbohydrate foods being administered over a period of less than 20 minutes. What is a nursing measure to prevent or minimize the dumping syndrome?
Administer the feeding with the patient in semi-fowler's position to decrease transit time influenced by gravity.
The nurse is inserting a nasogastric tube for a patient with pancreatitis. What intervention can the nurse provide to allow facilitation of the tube insertion?
Allow the patient to sip water as the tube is being inserted.
The physician ordered a nasoenteric feeding tube with a tungsten-weighted tip. The nurse knows to obtain what kind of tube?
Dobbhoff
Single-lumen, plastic, or rubber nasogastric tube about 4 ft in length
Dobbhoff or EnteraFlo tube
The nurse assesses a patient who recently had a nasoenteric intubation. Symptoms of oliguria, lethargy, & tachycardia in the patient would indicate to the nurse what common complication?
Fluid volume deficit
What is the visual difference between the color of gastric aspirate & the color of intestinal aspirate?
Gastric aspirate is most frequently cloudy & green, tan, off white, or brown & may be large volume. Intestinal aspirate is primarily clear & yellow to bile colored & typically smaller volume.
Double-lumen, plastic nasogastric tube about 20cm in length
Gastric-Sump tube
Nasoenteric feeding tube about 6 ft. in length
Levin tube
The nurse is caring for a patient who has a gastrostomy tube feeding. Upon initiating her care, the nurse aspirates the gastrostomy tube for gastric residual volume & obtains 200 mL of gastric contents. What is the priority action by the nurse?
Place the patient in a fowler's position with the head of the bed at 45 degrees.
Triple-lumen, rubber nasogastric tube (2 lumens are used to inflate the gastric & esophageal balloons)
Sengstaken-Blakemore tube
The nurse is inserting a sump tube in a patient with Crohn's disease who is suspected of having a bowel obstruction. What does the nurse understand is the benefit of the gastric (Salem) sump tube in comparison to some of the other tubes?
The tube is radiopaque
The nurse is inserting a nasoenteric tube for a patient with a paralytic ileus. How long does the nurse anticipate the tube will be required? Select all that apply.
Until bowel sound is present Until flatus is passed Until peristalsis is resumed
The nurse checks residual content before each intermittent tube feeding. When should the patient be reassessed?
When the residual is greater than 200 mL
The nurse is caring for a comatose patient & administering gastrostomy feedings. What does the nurse understand is the reason that gastrostomy feedings are preferred to nasogastric feedings in the comatose patient?
Gastroesophageal sphincter is intact, lessening the possibility of regurgitation
A nurse prepares a patient for insertion of a nasoenteric tube. What position should the nurse place the patient in?
In high fowler's position
The nurse is managing a gastric (Salem) sump tube for a patient who has an intestinal obstruction & will be going to surgery. What interventions should the nurse perform to make sure the tube is functioning properly?
Keep the vent lumen above the patient's waist to prevent gastric content reflux
Name three common causes of constipation for a patient who is receiving enteral feedings.
Possible causes for constipation include: concomitant use of opiods; administration of fiber free tube feeding formulas; & inadequate water intake (tube feedings typically do not meet total fluid needs, so additional water must be administered).
The nurse is inserting a Levin tube for a patient for gastric decompression. The tube should be inserted to 6-10 cm beyond what length?
The distance measured from the tip of the nose to the earlobe & from the earlobe to the xiphoid process
The nurse is inserting a nasogastric tube & the patient begins coughing & is unable to speak. What does the nurse suspect has occurred?
The nurse has inadvertently inserted the tube into the trachea.
Describe the purpose of gastric intubation.
The purpose of gastric intubation is to decompress the stomach & remove gas & fluid; lavage (flush with water & other fluids) the stomach & remove ingested toxins or other harmful materials; diagnose GI disorders; administer tube feedings, medications, & fluids; compress a bleeding site; & aspirate GI contents for aspirate.
When giving an initial tube feeding, the nurse would be looking for _____ around the tube site on the abdomen.
leakage of fluid
Prokinetic agents can be administered to facilitate _____ movement of the feeding tube into the duodenum.
peristaltic
Feeding patients through tubes placed beyond the _____ or using _____ agents can decrease the frequency of feeding regurgitation & aspiration.
pylorus, prokinetic
Nasogastric feeding tubes are used for patients who have the ability to _____ & _____ nutrition, fluids, & medications adequately by the gastric route.
receive, process