Gimme a Reason
It's Complicated
Better Not!
It Goes Where?
Feed Me!
100
This involves the instillation of a balanced salt solution through a gastric tube, followed by withdrawal of the fluid from the stomach
What is "lavage"?
100
Risk of this fungal infection may be reduced with proper oral care.
What is oral candidiasis, or "Thrush"?
100
The absence of this protective response is worrisome and may preclude placement.
What is a pharyngeal, or "gag", reflex? CNS - Pharyngeal reflex: 1. the sensory limb is mediated predominantly by CN IX (glossopharyngeal nerve) 2. the motor limb by CN X (vagus nerve).
100
This position assists with placement, guiding the tube anteriorly while reducing the risk for aspiration.
What is high "Fowler's" position?
100
This is the recommended daily allowance (RDA) for protein in a metabolically stressed person.
What is 1.5 - 2 Grams protein/kg of body weight?
200
This gastric tube, inserted through the nose, and may be used for feeding and / or to reduce gastric distention, shares a name with a "wicked" Massachusetts town.
What is a "Salem" sump tube?
200
This avoidable complication may lead to asphyxia, pneumonia, or abscess formation.
What is aspiration?
200
This narrowing of the esophagus make prevent patient participation in NG Tube placement, and may make passage of an NG Tube difficult, if not impossible.
What is esophageal stricture?
200
Extending the end of the tube from the tip of the xyphoid process to the tip of the earlobe, then to the tip of the nose. Apply a piece of tape at this point.
What is the method of measuring the length of tube to be inserted.
200
This method of feeding closely mimics normal feeding time and intervals, requires less time and equipment, and offers greater flexibility to the patient.
What is bolus feeding?
300
This nasally placed tube, often used for long term feedings, requires frequent monitoring due to its tendency to clog.
What is a small bore or "Dobhoff" feeding tube?
300
Long term placement of a naso-gastric tube may predispose a patient to develop this abnormal connection between the esophagus and trachea.
What is a "tracheal-esophageal fistula"?
300
These two caustic substances, if ingested, may chemically irritate or burn the esophageal lining, increasing risk of hemorrhage or perforation from attempted NG Tube placement.
What is alkali and acid substances?
300
On tube insertion, some resistance may be felt at this point, but often easily overcome with gentle pressure and / or a slow twist applied to the tube permitting passage.
What is the posterior nasopharynx?
300
To decrease the risk of aspiration, this is the length of time a patient should remain in a semi Fowler's or high Fowler's position after a bolus feeding.
What is at least 30 minutes?
400
This elegant sounding term is often associated with providing nourishment for infants, but may also be applied to feeding an adult via a gastric tube.
What is "Gavage"?
400
This event, which may occur during a difficult NG Tube placement, will often cause a nurse's ego to "deflate".
What is a pneumothorax?
400
This term describes any number of physical, chemical, or mechanical conditions along the GI tract that impede the up-take and utilization of nutrients, making enteral nutrition impractical and ineffective.
What is a malabsorption condition? These include IBD, colitis, ileus, celiac disease, tumors, vitamin deficiencies, and other conditions that interfere with the normal bio-mechanical process of absorption.
400
Signs of this condition may include wheezing, coughing, gasping, or cyanosis when a tube is inadvertently inserted into the trachea.
What is Respiratory Distress? Withdraw the tube to just above the posterior nasopharynx, let the patient recover, and prepare to re-attempt insertion.
400
When aspirating gastric contents for feeding residual, the volume should not exceed this percentage of the feeding pump hourly rate.
What is 110%? Re-instilling the aspirate / residual will help maintain the gastric pH, and preserve the gut's normal flora, decreasing the opportunity for C.Difficile overgrowth.
500
This device, when properly applied to the vent port of a Salem Sump tube, prevents a vacuum effect, allowing gastric content to be more easily aspirated by suction.
What is an anti-reflux valve?
500
This unpleasant complication may result from administering a feeding in large volume, too fast, from contaminated solution, or from medication.
What is diarrhea?
500
The presence of this clear or blood-tinged liquid upon examination of the ears or nose is a clear contraindication to any nasal or oral gastric tube placement.
What is cerebrospinal fluid (CSF)? The presence of CSF indicates a cranial fracture, and potential tube migration to the intracranial space.
500
This is considered to be the "Gold Standard" for verifying NG Tube placement.
What is a chest x-ray? Instillation of air / auscultation, and aspiration of gastric content / pH <5.0 are signs of placement until a CXR is obtained. Tube feedings / meds are held until the tube placement is confirmed by CXR.
500
It is important to administer free water with prepared enteral feeding formulas for this reason.
What is preventing dehydration? Prepared enteral feedings are calorically dense, many are protein rich, and do not contain water.
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