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26 Cards in this Set
- Front
- Back
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Mosby's definition of enteral
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Within the small intesting
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Nurse's definition of enteral
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Term is used broadly to include the stomach, duodenum, and jejunum
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Enteral tube Uses
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Stomach Decompression
Removing Stomach contents To help the bowel function get rid of anesthesia Lavage of the Stomach Compression of Stomach or Esophagus Feeding Med Administration |
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The process of Lavaging the stomach
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A) Iced Saline is placed into the tube using a 50-60cc catheter tipped syringe and then removed
B) Same process as above but with normal temp saline |
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Why are each processes of laving the stomach used?
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Iced: Stop bleeding
Normal: Remove poisonous meds |
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How is the stomach/esophagus compressed?
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A special ballooned enteral tube used to stop hemorrhage from gastric ulcers or esophageal varices
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How is food and meds administered through an enteral tube?
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Tube is fed directly into the stomach or small intestine
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Medical Diagnoses that associate with Enteral nutrition
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Stroke resulting in dysphagia
Esophageal cancer needing surgery Head/Neck cancers needing radiation Facial trauma from car accident |
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What are the different feeding routines
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Continuous
Intermittent |
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Continuous Feeding Route
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Pump used to deliver nutrition over 12/24 hours. Ordered by physician as cc/hr x # of hours
Uses "open" or "closed" system |
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Intermittent Feeding Routine
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Nurse administers food using gravity and 60cc syringe. Liquid feeding is poured into the syringe, plunger is removed.
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Difference between "open" and "closed" tubing system
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Open - Max of 4 hours of feeding to be instilled at one time by the nurse
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Nasogastric Tube
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Hard plastic tube going into the stomach, usually only 2 weeks. Uses either the Salem Sump or Levine tube.
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What's the difference between salem sump and levine tube
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The levine tube has an air vent
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Gastrostomy Tube
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Tube through the abdomen into the stomach
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Duodenal Tube
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tube into the duodenum through either the nose or mouth. Made of soft plastic that is weighted at the end
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How is the Dbhoff duodenal tube moved to the duodenum when inserted
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Peristalsis
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Jejunostomy Tube
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Tube into the Jejunum through the abdominal approach and sutured in place.
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Care for enteral tube sites
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Assess s/s of infection
Change tape when soiled Rubber band/safety pin to secure NG to gown Follow policy for cleaning (Saline for encrustation) Consider pressure caused by gauze for g-tube Prevent traction to avoid unexpected removal |
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Patient Position for safety
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Fowler's position with head of the bed at 30-45 degress elevation at all times
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How do you verify the placement of the tube
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check pH of gastric residual.
Gastric pH: 4.0 Intestine pH: 5.0 Lung pH: 7.0 |
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How do you document the amount of residual
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every 4 hours and before med admin
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when would you hold a feeding or med
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If the residual >100ml and then proceed to double hourly infusion rate
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Why would you return the residual to the pateitn
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Maintain electrolyte balance and digestive secretions
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What lab values would you monitor
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Nutrition
Bleeding Repeated episodes of diarrhea All depending on the patient |
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How is the appropriate enteral feeding chosen
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Nutritional assessment by a registered dietitian including BMI, med history, lab values, and caloric needs
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