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17 Cards in this Set

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Blakemore Sengstaken Tube
used for someone who has esophageal varices -- back flow of stuff in the liver
- can be placed through nose or mouth
decompression feeding:
suction out contents of stomach - fluid or air
varicos veins:
enlarged veins and bulge out, everyonce in a while, they rupture (if they rupture, patient will hemorrhage)
lumen:
at the end of tube
cantor tube and miller abbott tube
both go in small intestine
NEX ==
nose, earlobe, xyphoid process
three things to check placement of NG tube
1. aspirat stomach content with large end syringe
2. insert bolus of air and listen for sound in LUQ
3. check gastric ph of 4 or less -- acidic
if stuff other than air is coming out of air vent, then need to:
IRRIGATE
intermittently irrigate tube to maintain:
and then...
patency

--aspirate after irrigation
if aspirant is less than irrigant = output
if aspirant is greater than irrigant = intake
when discontinuing an NG tube:
patient needs to hold breath, so make it snappy!
-remove tube into a towel
Feeding tube -- DOBB HOFF
36" (pink) for gastric
43" (green) for duodenal - has wire, take it out once in patient after x-ray
55" (brown) for jejunal
PEG or Jejunal --
surgically inserted feeding tube
Percutaneous Endoscopic Gastrostomy
Gastric placement-

Small bowel-
NEX + 2 cm

NEX + 25 cm
Checking for airflow
as the patient exhales, dip the tip of the stylet into a cup of water. if bubbling occurs pull the tube back into the oropharynk and start again. if no bubbling occurs quickly inject 20 ml of air and watch to see if patient burps. REMOVE tube from H20 before patient inhales (risk of aspiration)
AUSCULTATION
use a 60 ml syringe and draw up 60 ml of air. inject air into the tube in 15 cm air bursts while listening (with stethoscope) over the LUQ, epigastric area, RUQ, and RLQ (in succession)
-the sound should be loudest over the LUQ or Epigastric if gastric placement
Vacuum effect:
immediately after listening at the RLQ pull the plunger on the syringe back to the 40 ml mark and let go.
-if the plunger returns to <10ml mark, advance the feeding tube 5 cm and recheck
-air should easily be withdrawn from the stomach and when >30 ml is noted on release of plunger
for duodenal placement... once you know you have gastric placement:
turn patient on their right side. then advance the feeding tube an additional 25 cm while injecting 5-10 ml bursts of air. then rotate the tube in a clockwise direction as you advance to the 75 cm mark.