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CH 38 M IV

CH 38 Digestive - Tube feedings

Tube feedings: What position should pt. be in? Why? How long after feeding? Fowlers; prevent aspiration; 30 mins
Tube feedings: What is the most critical assessment? confirmation of placement
Tube feedings: What is the most reliable way to confirm placement. radiograph
Tube feedings: confirming placement of a tube is required before or after feedings? before
Tube feedings: which type tube (small or large) does not require confirmation of placement? large bore tube
Tube feedings: Name three reliable tests to confirm placement. Observation of aspirated material, assessment of pH
Tube feedings: stomach contents are-name 4 characteristics grassy green, clear and colorless, or brown
Tube feedings: what is the pH of stomach secretions? five or less
Tube feedings: intestinal pH is normally what? Six or higher
Tube feedings: what are for methods that lacks scientific support for confirming placement? stethoscope over the abdomen while injecting air, placing tube in the water to see bubbles, patient's ability to speak, and I was surfing for respiratory symptoms
Tube feedings: when patient has continuous feedings, placement is usually checked how many times at least once every shift
Tube feedings: why is residual monitored? Prevent overfilling of the stomach
Tube feedings: Formula remaining in the stomach from a previous feeding residual
Tube feedings: how do you check for residual? syringe to aspirate/withdraw and measure
Tube feedings: after measuring, what do you do w/ the residual? returned through the tube to prevent loss of electrolytes
Tube feedings: name the five rights for feeding right formula, right amount, right dilution, right schedule, right pt.
Tube feedings: initial tube feedings are diluted to what strength? one half or one fourth strength
Tube feedings: If a pt. can tolerate the feeding, do you give the highest concentration? no, concentration is gradually increased
Tube feedings:what appropriate action should the nurse do if the patient has nausea or pain? Notify physician, stop the feeding
Tube feedings: Rinse the tube by flushing at least how many mLs of water? 30 mL
Tube feedings: if diarrhea occurs, what can you request from the physician? request decreasing the concentration or the rate of delivery or both for the formula.
Tube feedings: what may occur with rapid feedings of concentrated formula? Dumping syndrome
signs and symptoms of dumping syndrome cold sweat, abdominal distention, dizziness, weakness, rapid pulse rate, nausea, diarrhea
name the steps for feeding with a syringe. Removed plunger from the barrel of the syringe,attached a barrel to the feeding tube, kink the tube to prevent air while pouring formula, hold barrel 12 inches above stomach, allow gravity
Tube feedings: how many inches should the barrel be held above the stomach? Why is this done? 12 inches; allows gravity to put formula down tube
Tube feedings: if using infusion pump to deliver feeding, what should the nurse due to reduce the amount the air forced into the digestive tract? fill tube w/ formula before connecting it to the feeding tube
Continuous feeding: How many hours worth of formula is given? Why can't you give more? no more than 6 hours worth; prevent contamination
What is the usual amount per hour given in a continuous feeding? 80-150 ml
Bolus feedings are given when? specified intervals
Bolus feedings are how many mLs over how long 30-40mLs over 30 to 45 mins
Tube feedings: what should be changed every 24hrs? tubing and bag
Created by: Jgar2007