Gimme a Reason
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"?
Risk of this fungal infection may be reduced with proper oral care.
What is oral candidiasis, or "Thrush"?
The absence of this protective response is worrisome and may preclude placement.
What is a pharyngeal, or "gag", reflex?
This position assists with placement, guiding the tube anteriorly while reducing the risk for aspiration.
What is high "Fowler's" position?
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?
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?
This avoidable complication may lead to asphyxia, pneumonia, or abscess formation.
What is aspiration?
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?
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.
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?
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?
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"?
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?
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?
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 30-60 minutes?
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"?
This event, which may occur during a difficult NG Tube placement, will often cause a nurse's ego to "deflate".
What is a pneumothorax?
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.
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.
When aspirating gastric contents for feeding residual, when would I hold the feeding?
What is 500ml x1 or 250ml x 2
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?
This unpleasant complication may result from administering a feeding in large volume, too fast, from contaminated solution, or from medication.
What is diarrhea?
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.
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.
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.