Care Of A Client With A Tube

Front 1

Levin (nasogastric tibe)
description/use

Back 1

single lumen NG tube.
used to remove gastric contents via intermittent suction or provide tube feedings

Front 2

Salem Sump (nasogastric tube)
description/use

Back 2

double lumen NG tube with an air vent(pigtail)
*air vent is not to be clamped and is to be kept above stomach level*
*if leakage occurs through the air vent, instill 30ml of air into vent and irrigate the main lumen with NS per agency policy

Front 3

Determining NG placement

Back 3

1.most reliable method is x-ray. should be performed after initial placement.
2. determine tube placement every 4 hours b4 adm of food and meds.
3. aspirating gastric contents and measuring PH (should be 4 or lower)
4. Insert 5 to 10 ml of air into NG tube and listening, should hear a gush nof air over the stomach with a stethoscope.

Front 4

checking residual of NG placement

Back 4

1. Check residual every 4 hours b4 feeding and meds.
2. Aspirate all stomach contents measure amount.
3. Reinstill residual feeding to prevent electrolyte and fluid losses, unless the volume exceeds 100ml, appears abn.
*if residual is less than 100 feeding is being administered

Front 5

irrigating NG

Back 5

1.perform every 4 hours to check patency of the tube.
2. check placement b4 irrigating
3. instill 30-50ml of water or NS with an irrigation syringe
4. pull back syringe to withdraw fluid to check patency, repeat if tube remains sluggish

Front 6

removal of NG tube

Back 6

tell pt to take a deep breath and hold, remove the tube slowly in 3 to 6 seconds. Coil tube around hand as its being removed.

Front 7

GI feeding tube types

Back 7

NG; nose to stomach
gastrostomy; stomach
jejunostomy- jejunum

Front 8

types of GI tube feeding administration

Back 8

intermittent(bolus)-resembles normal feeding pattern. 300-400 ml of formula is administrated over 30 to 60 minutes q 3-6 hours.
2. Continuous-adm. continuously over 24 hours, infusion pump regulates flow.
3. cyclical- adm. either day or night for 8-16 hours, infusion pump regulates flow.

Front 9

positioning of GI patients

Back 9

hob elevated 30 degrees at all times
comatose- right side

Front 10

GI feeding precautions

Back 10

Do not allow food to hang for more than 4 hours (bacterial growth)
check exp. date b4 administering
shake formula well b4 administering

Front 11

intestinal tube-description and type

Back 11

pass nasally into the small intestine.
used to decompress the bowel and remove intestinal contents

CANTOR/HARRIS TUBE-single lumen
MILLER ABBOTT tube- double lumen

Front 12

instestinal tubes intervention

Back 12

1. position client on right side
2. xray determines placement
3. check the abd. measure the girth
4. if tube is blocked notify rn OR dr. small amount of air to be inject might be prescribed

Front 13

esophageal and gastric tubes- description

Back 13

used to apply pressure against esophageal veins to control bleeding.
(not used w pts that have ulcerations or necrosis of the esophagus, or had previous esophageal surgery

Front 14

Sengstaken Blakemore tube

Back 14

triple lume tube with an inflatable esophageal balloon, an inflatable gastric balloon,and a gastric aspiration balloon.

Front 15

Sengstaken Blakemore tube- interventions

Back 15

Client is placed in high fowlers for tube insertion.
Monitor for resp distress , if occurs notify RN, tubes will be cut to deflate balloons.
Monitor for esophageal rupture(drop in bp, back and upper abd. pain) its an emergency must be reported immediately.

Front 16

urinary catheter care

Back 16

1.use gloves, wash the perineal area w warm water
2. with the nodominant hand pull back the labiaor foreskin to expose the meatus.
2. Clean along the catheter w soap and water
3. anchor catheter to thigh
4. maintain the catheter bag BELOW the level of the bladder

Front 17

__ tube can cause __ and __ __ damage.

Back 17

Endotracheal
mucosal, vocal cord

Front 18

whats the reason for endotracheal tube (ET tube)

Back 18

used to maintain a patent airway.
indicated when pts need mechanical ventilation

Front 19

orotracheal tube- description

Back 19

inserted through the mouth.
indicated when the client has a nasal obstruction or a predisposition to epistaxis
uncomfortable and can be manipulated by the tongue

Front 20

nasotracheal tube-description

Back 20

requires the use of a smaller sized tube.
discouraged for clients w bleeding disorders

Front 21

extubation

Back 21

1.hyperoxygenate the client, suction the endotracheal tube and oral cavity
2. semi fowlers position
3. cuff is deflated, have pt inhale, at peak inspiration the tube is removed and airway is suctioned through the tube as it is pulled out.
4. cough and deep breathe

Front 22

chest tube draining system- description

Back 22

returns neg pressure to intraplural space
used to remove abnormal accumulation of air and fluid from the the pleural space

Front 23

water seal chamber

Back 23

tip of the tube is underwater, thus allowing fluid and air to drain from the pleural space and preventing air from entering
water oscillates(moves up as pt inhales move down as the pt exhales
*CONTINUOUS bubbling indicates an air leak in the chest tube system*

Front 24

suction control chamber

Back 24

provides suction which can be controlled by neg pressure to the chest
gentle bubbling indicates that there is suction

Front 25

collection chamber-interventions

Back 25

Monitor drainage- physician is notified if drainage is more than 100ml/hr, or bright red and increase suddenly
mark chest tube drainage in the collection chamber every 1-4hour intervals

Front 26

water seal chamber- intervention

Back 26

monitor fluctuation of the fluid level
fluctuation stops if the tube is obstructed
continuous bubbling indicates air leak in the system(notify rn and physician

Front 27

If the chest tube is accidentally pulled out of the chest, what should you do?

Back 27

Pinch the skin opening together
apply occlusive sterile dressing
cover the dressing with overlapping 2inch tape
notify the rn and dr. stat