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32 Cards in this Set
- Front
- Back
Why would a client need to be given TPN ?
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GI tract is not usable
severe malnutrition bowel disease disorder acute renal failure hepatic failure metastatic cancer Severe disease states Burns major surgeries |
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How is parenteral nutrition administered?
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intravenously such as through a central venous catheter into the superior vena cava.
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Why would a client need to be given TPN ?
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GI tract is not usable
Severe disease states Burns Long or short term nutritional support |
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What type of solution is used when giving TPN?
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HYPERTONIC
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What does the parenteral nutrition solution consist of ?
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glucose
protein hydrolsates minerals vitamins |
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The nurse knows that when using a small -bore tube that.....
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to leave the stylet or guide wire in place until placement is verified by x-ray
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What method for determining tube placement is least effective?
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auscultating the injected air.
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Why is a nasogastric tube taped to the client's nose?
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to avoid irritaion the nostril
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After insertion what does the nurse need to do to the nasogastric tube?
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clamp the end of the tube or hook it up to suction, and pin to clients gown
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What are the ways a nurse can verify tube placement?
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initial x-ray examination
aspiration of gastric pH ausculation of injected air the graduated marks on the tube |
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Intermittent feeding
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300-500 ml. several times a day
stomach is the preferred site administered over 30 minutes |
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bolus intermittent feedings
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given by syringe
delivered to the stomach delivered rapidly not recommended for long-term situation unless client tolerates them. client monitored for distention |
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Continuous feedings
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administered over 24 hour period
used with a pump essential for small bowel feedings used with small-bore gastric tubes or when gravity flow is insufficient to instill the feeding. |
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What temperature should tube feedings be ?
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room temperature
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Hot feedings can cause ?
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irritate the mucous membrane
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cold feedings can cause?
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cramping
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dumping syndrome
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nausea
vomiting diarrhea cramps pallor sweating heart palpitations increased heart rate fainting after a feeding |
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What clients would experience a dumping syndrome?
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jejunostomy
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What causes the "dumping syndrome" in jejunostomy clients?
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results when hypertonic foods and liquids suddenly distend the jejunum. to make the intestinal contents isotonic, body fluids shift rapidly from the client's vascular system
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What should the nurse assess before administering tube feeding?
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allergies to any food in the feeding.
bowel sounds before q feeding or q4-6 hours for continuous feedings. correct placement presence of regurgitation/feelings of fullness. dumping syndrome distention diarrhea,constipation, flatulence urine for sugar and acetone hematocrit and urine specific gravity serum BUN and sodium levels |
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Why is the hematocrit and urine specific gravity test done on a client receiving a tube feeding?
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both increase as a result of dehydration.
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Serum BUN and sodium levels are monitored in clients receiving tube feedings to assess?
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due to high protein and inadequate fluid intake the test are done to monitor the if the kidneys are able to excrete nitrogenous waste.
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When administering a jejunum or gastrostomy feeding the nurse must first?
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remove the ostomy dressing
lubricate the feeding tube to be used insert the tube 10-15cm or 4-6 cm. or check the patency of a tube that is in place and determine placement. |
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common complications of enteral feedings?
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aspiration
hyperglycemia abdominal distention diarrhea fecal impaction |
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small bore tubes
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silicone rubber feeding tube
decreases irritation to nose and throat more difficult to insert prevent regurgitation: less chance of aspiration. |
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gastric sump pump
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2nd lumen to provide air vent
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Duo tube the nurse should assess for
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nausea
vomiting distention pain |
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Ewald tube
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very large lumen 26-30 lumen
used for lavage- OD or other poisonous agents. also used for diagnostic purposes |
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Canter tube and Baker tube
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long single lumen rubber tube with a rubber bag attached to its distal tip.
contains 30ml. of mercury in the bag usually inserted by a physician |
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Miller-Abbot Tube
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long, double lumen rubber tube
inserted as NGT and the bag is inflated used for a small bowel obstruction both lumen openings must be clearly marked. |
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Reason for tube feeding obstructions
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formulas w. large molecular size
re feeding partially digested gastric residual. formula rates less than 50ml.hour instilling crushed or hydorphilic medications into tube. not flushing before/after feedings or medications |
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major danger of continuous tube feedings.
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aspiration
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