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Pediatrics.Ch.22.
Nutrition, Digestion, Elimination
| Question | Answer |
|---|---|
| What is a gastrostomy | Opening into the stomach to introduce food through the abdominal wall by means of a surgically placed tube or button |
| Which patients need sterile equipment for gastrostomy tube feeding | Preterm and Newborn |
| How should a child be positioned for gastrostomy tube feeding | Flat or with HOB slightly elevated |
| What amount of residual requires modification of feeding amount | 10 – 25 ml/newborns, 50 ml/older children |
| What are the steps for gastrostomy feeding | Position, Residual & Placement, Attach & Fill syringe, remove Clamp, Elevate receptacle, Add formula before empty, Clamp or Raise, Fowler’s, Hands, Document |
| What can overloading the stomach of a gastrostomy fed patient cause | Reflux, Aspiration |
| What action is taken if too much residual is in the stomach before feeding | Formula reduced by amount of residual or Delay feeding |
| If ordered, how much water is typically used to flush the tube | 15 – 30 ml |
| What is documented regarding gastrostomy feeding | Type, Amount and Character of residual, How tolerated, I&O |
| What indicates that a gastrostomy tube has slipped through the pylorus into the duodenum | Brown or green drainage |
| What does brown or green drainage from a gastrostomy tube indicate | The tube has slipped through the pylorus into the duodenum |
| What can happen if a gastrostomy tube slips through the pylorus into the duodenum | Obstruction |
| What is different than adults in administration of an enema to a child | Type, Amount, Distance, More easily perforated bowel |
| What is used for a child’s enema | Isotonic/Saline solution |
| Why is tap/plain water contraindicated for children’s enemas | Plain water is hypotonic to the blood and could cause a rapid fluid shift and overload if absorbed through the intestinal wall |
| What are guideline ranges for the amount of enema fluid administered to a child | 50ml/infants – 750ml/adolescent |
| How far is a child’s enema tube inserted | 1 – 4 inches |
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futurenurse
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