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Nursing 132

module 15 post test 1 Enternal nutrition

QuestionAnswer
A tube feeding is administered into the _________ or the ______ ________. stomach, small intestine
Candidates for tube feeding include patients who have adequate digestion and absorption, but cannot ingest, chew, or swallow food safely or in adequate amounts
The selection of the type of tube and placement method depends on anticipated duration of feeding and other patient-related factors, such as gastric emptying and risk for pulmonary aspiration
The most serious complication of tube feeding is pulmonary aspiration
For short-term feeding _______ or __________ feeding tubes are appropriate nasal or oral
Nasogastric tube feedings are typically used for short-term, usually less than _________ days. 30
The nurse suspects the patient’s feeding tube has migrated. what would indicate the greatest risk related to tube migration? Dyspnea and decreased oxygen saturation
The nurse observes a confused patient pulling at her NG feeding tube. As the nurse re-tapes the tube to the bridge of the patient's nose, the nurse notices that the mark on the tube has moved away from the naris. What action should the nurse take? Advance the tube until the mark is even with the naris and verify correct tube placement.
Identify signs and symptoms of accidental respiratory migration of a feeding tube. coughing, choking, or persistent gagging; decreased pulse oximetry; cyanosis; or change in respiratory patterns (e.g., increase in rate)
Identify the appropriate times to verify enteral tube placement by pH testing b4 each intermittent feeding, at least 1x Q 6 hrs when cont. feedings,& b4 meds are adm. by tube, wait at least 1 hr after med. adm. b4 aspirating gastric contents.
Which of the following, if exhibited by the patient, may increase the risk for spontaneous enteral tube dislocation? vomiting, nasotracheal suctioning, and severe bouts of coughing
Gastric fluid from a patient who has fasted for at least 4 hours usually has a pH range of 1-5
Fluid from an NI tube of a fasting patient usually has a pH greater than 6
A patient with continuous tube feeding may have a pH of 5 or higher
The pH of pleural fluid from the tracheobronchial tree is generally greater than 6
Sequence the procedure for verifying feeding tube placement. hand hygiene. Apply clean gloves. Draw up and instill 30 mL of air. Draw 5/10 mL of aspirate. Observe color, mix aspirate. dip strip into fluid, compare color of strip with chart, helps verify tube location. Discard used supplies,hand hygiene
If the nurse suspects the NG feeding tube has migrated, the nurse should: Stop any enteral feedings and obtain an order for a chest x-ray to determine placement.
Created by: 1237552963