NG Tube
*Preventing Complications of Enteral Feeding* Administer __________ and _________ supplements as ordered by physician
phosphorus potassium
How to measure the distance to insert tube
place tube at tip of the patients nostril to the tip of the earlobe and to the tip of the xiphoid process tape the marking
lubrication of tubing
2-4 inches
*Preventing Complications of Enteral Feeding* What are the appropriate interventions to prevent potential complications from a clogged feeding tube?
Flush tube before and after feeding, every four hours during continuous feeding, and after withdrawing aspirate. Instill 30 mL of water with 50 or 60 mL syringe
What should the nurse instruct the patient to do when the pharynx is reached?
Instruct patient to touch chin to chest. Encourage the patient to sip water or swallow. Advance the tube when patient swallows
*Preventing Complications of Enteral Feeding* Monitor for _____ weakness that can progress to respiratory failure (due to decreased phosphorus in the cells).
Muscle
*Preventing Complications of Enteral Feeding* Assess for _________ depletion
Potassium
What should the nurse do if the patient begins gagging/coughing?
Stop advancement of tube and check placement
Nursing interventions when using a salem sump
Secure the airvent above the stomach level. This prevents seepage of gastric contents
Gastric residual
The amount of feeding remaining in the stomach from the previous feeding
A nurse has just inserted a nasogastric tube in a client. Which of the following is the most reliable method for verifying correct tube placement? a) Radiographic confirmation of position b) Off-white fluid aspirated c) Green fluid with particles inside d) Confirmation that pH of the aspirate is less than 5.5
a) Radiographic confirmation of position
*Preventing Complications of Enteral Feeding* What are the appropriate interventions to prevent potential complications from aspiration?
Use appropriate measures to check tube placement. Elevate head of bed at least 30 degrees during feeding and for 1 hr afterward. Give small, frequent feedings. Avoid oversedation of patient. Check residual volume per policy
A nurse is assessing a client who has recently had a bowel surgery and will be receiving an NG tube. Which of the following would most likely contraindicate the nurse placing the NG tube? a) History of facial fractures b) Bleeding in the GI tract c) Abdominal distention d) One nare being less patent than the other
a) History of facial fractures
Identify reasons an NG tube would be placed in a client. Select all that apply a) To remove undesirable substances, such as poisons b) To facilitate weight loss c) To monitor for bleeding in the GI tract d) To drain unwanted fluid and air from the stomach e) To allow the intestinal tract to rest after bowel surgery f) To deliver nutrients
a) To remove undesirable substances, such as poisons c) To monitor for bleeding in the GI tract d) To drain unwanted fluid and air from the stomach e) To allow the intestinal tract to rest after bowel surgery f) To deliver nutrients
how to select appropriate nostril to insert tube
ask the patient to breathe through each nostril and use whichever one is easiest to breathe
The nurse is slowly advancing an NG tube when the patient begins to gasp & is unable to vocalize. Which of the following has likely occurred? a) The client is experiencing a nasovagal reaction b) The NG tube is in the clients airway c) The NG tube is curled in the back of the clients throat d) The client is forcefully resisting the procedure.
b) The NG tube is in the clients airway
assess abdomen for _________ & _________
distention & firmness