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21 Cards in this Set

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If the GI tract is not functioning or must be by-passed for a medical condition, tube feeding will not work, in these cases, _____ ____ _____ is used. Fluids containing essential nutrients that are infused directly into the venous system.
Total parenteral nutrition
Salem sumps: 12-18 fr nasogastric tubes are used for temporary tub feedings and can also be used to do what?
decompress the stomach
Small bore weighted feeding tubes are anywhere from ____ -____ fr. these tubes have a stylet in place to help stiffen the small tube to allow for insertion. The stylet is removed post insertion. Never reinsert the stylet as there is a risk of perforation of the gut.
7-12
This is a small diameter tube that is placed through a surgical incision in the abdominal wall and into the jejuneum.
jejunostomy tubes or J tubes.
This larger diameter short tube is placed into the stomach through the abdominal wall. They have a ballon on the end to help with placement.
gastric tubes or G Tubes
These tubes are placed either during an operative procedure requiring general anesthesia or during an endoscopic procedure that requires conscious sedation, what are the names of these two tubes?
peg or pej tubes
What three ways are feedings administered?
bolus, gravity drip or pump
What position should you place the patient in to reduce the possibility of aspiration of formula into the lungs.
high fowlers or at least 30 degrees
J tubes should be checked with an ____ for placement before initial instillation of liquids and as needed for suspicion of inadvertent tube misplacement.
x-ray
_____ tubes should be checked for placement prior to each bolus feeding or each medication administration and periodically (q 4hours) during intermittent feeding.
nasogastric
Traditional check of tube placement is insufflation of air while listening over the ____ area.
gastric
Other tecniques of placement checks include gastric aspiration.
-Check aspirate for appearance (grassy green, clear and colorless, cloudy white)
-check aspirate for pH
-- gastric contents should have pH equal to or less than ___.
5
With ____ feedings this residual check should be done before each feeding.
intermittent
With continuous feedings the check should be done at least every ____ hours.
eight
An exception is ____ feeding tubes in which gastric residuals cannot be checked.
jejunostomy.
Method
Disconnect feeding set from the feeding or unplug the tube
Insert a ____ syringe (adults) or 20 ml syringe (peds) into the end of the feeding tube.
Pull back on the syringe until no more gastric contents can be aspirated. May need to empty syringe into a clean measuring containor and aspirate more if the residual is more than the contents of one syringe.
50-60 ml
What is the most common complaint withh tube feedings?
diarrhea
Diarrhea can be caused by high osmolarity of feeding, feedings may need to be started at _____ strength.
1/4 or 1/2
How often should a feeding set up be changed?
every 24 hours
If a tube is obstructed and you suspect it to be up against folds in stomach, try _____ or insufflation of air or change patient position.
irrigation
If tube is occluded, try irrigation with ______, use 20-30 ml syringe to prevent tube rupture.
warm water