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31 Cards in this Set
- Front
- Back
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What is the best way to feed a pt?
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By mouth, the "normal way"
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Who cannot eat by mouth?
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NPO
Can't swallow (stroke, surgery on throat, throat cancer) Unconscious Vegitative state Someone that needs GI rest |
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Who do people who can eat by mouth get put on nutritional supplements?
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Because they need extra calories
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How do we give extra calories?
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By mouth ( High cal snacks/drinks)
Calorie supplements NG tubes (know Fr size for feeding) |
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What age group may need extra calorie supplements more than other age groups?
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Elderly
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How to encourage elderly to eat "better?"
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Put together in a room for socialization during mealtime
Give them time to eat! They m ay eat much slower than we are used to Bring in their favorite/ethnic foods |
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What type of pts need A LOT of extra calories?
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Burn victims, and pts with sepsis
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What do we need to know about an NG tube before feeding through ut?
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What size Fr?
On a pump or bolus? |
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What is the max time frame for an NG tube?
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2 week max
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What are problems with overfeeding through an NG tube?
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N/V, aspiration
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What is aspiration?
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What vomit or other liquid or particle goes into lungs
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How often to check residuals for NG tube pts?
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Q 4-6 hr
before feedings before meds at start of shift |
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S/S of aspiration
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cyanosis
coughing dyspnea low O2 sat |
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What angle to keep HOB at for NG tube pts?
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30-45 degrees
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Most tube feedings are more hyperosmotic or hyposmotic?
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Very hyperosmotic --> 300+ osmolarity
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Tube feedings must start out slow because of...
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Chance of DEHYDRATION and DIARRHEA
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What is a PEG?
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Percutaneous endoscopic gastrostomy
Or- G-Tube Tube inserted about 2 inches into a persons abdomen/stomach |
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When to flush a gastrostomy tube
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Flush with warm H2O before and after meals (40-50 mL)
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What type of meds to give through a gastrostomy tube
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No SR or time released medications (will clog tube)
Liquid meds are preferred |
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One of the main goals when caring for a G-Tube
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Need to prevent clogging
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What size tube is used for NG feeding?
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12Fr or smaller
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How to check initial placement of tube?
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An X-Ray!
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Other ways to check for tube placement after the initial X-ray?
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Checking pH of aspirant
Checking CO2 Injecting air and auscultating |
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How often to check and record residuals?
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4-6 hrs
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How often to change feeding tubes and bags?
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Q 24 hrs (to 48 hrs if not a closed system)
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How to prevent infection or bacterial growth for tube fed pts?
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Wear gloves when changing or opening system or adding product
Wipe off lids of formula cans Wear sterile gloves for immunocompromised pts |
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Do we use food coloring in formula to assess aspiration?
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No! It can cause serious complications
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D-Tube
J-Tube |
Duodenal feeding tube
jejunal feeding tube |
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Who removes tubes?
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Doctors
(sometimes pts will also.... not good!) |
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People on tube feedings are at risk for what?
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Refeeding syndrome
Tube misplacement and dislodgement Abdominal distention and N/V F & E imbalances |
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What is refeeding syndrome?
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Life threatening metabolic syndrome when nutrition is restarted for a person who is in starvation state. The new E shift can cause CV, Resp, and neuro problems
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