NURSING 317 EXAM 3 100% SOLVED
QUESTIONS AND ANSWERS
m what are some reasons a gastric/intestinal tube might be placed? - -gut decompression
-to deliver nutrients
-empty stomach of contents, toxins, or poisons
what are some reasons a NG tube would be placed for gut decompression? - -to prevent nausea and
vomiting post-op
-for a paralytic ileus
-for GI obstruction (to suck out the obstruction)
when would an NG tube be placed to deliver nutrients? - if the patient is not able to swallow
(delivering nutrients through the GI tract if functioning is better for the body than giving it IV)
what are some various characteristics of gastric/intestinal tubes? - -gastric (stomach) vs intestinal
intubation
-large bore vs small bore
-single lumen vs double lumen
-nasally inserted vs percutaneously inserted
why might a person have an intestinal tube placed (rather than gastric)? - if a person aspirates food or is
at high risk for aspiration, the tube may be placed beyond the stomach
what type of NG tube is a double-lumen? - double lumen Salem sump tube
what are two nursing implications for NG tubes? - -make sure you understand your suction (intermittent
or continuous) and how that would affect your patient
-make sure you know how to tell if the suction works
which would be better long-term: NG tube or PEG tube? why? - PEG tubes (or PED or PEJ) are meant for
long-term use; NG tubes can cause ulcers on the nose, back of the throat, etc. so they aren't meant to be
used long-term
why might an NG tube be placed in an infant? - if they dont have an adequate suck to get enough
milk/formula; an NG tube is easily placed every time they need to feed (the babies usually swallow the
tube themselves)
what is selection of an NG tube based on? - purpose and duration of treatment
what are some steps you must take before insertion of an NG tube? - -check nostril patency
, -ask patient about medical/surgical history in relation to the nose (deviated septum, previous nasal
surgery, etc.)
-measure the tube length
how do you measure the tube length for NG tube placement? - from the nose to the ear to the xiphoid
process; mark the end with tape so you know when to stop
if placing an intestinal tube, how do you measure the length? - measure the same way for gastric
placement, then add 15-20 cm
what must you do to a double lumen feeding tube/salem sump tube before placement? - "prime the
tubing" by flushing 10 mL of warm water so that the stylet can be easily removed
when do you remove the stylet? - after placement is confirmed with a chest X-ray
when might a gastric tube be placed orally? - if the patient has a deviated septum or other nasal
condition (such as severe facial fractures) that would not allow a tube to be inserted nasally
how many times can you attempt to put in an NG tube before getting assistance? - 3 times
true or false: you must lubricate the tip before insertion - true
makes the tube go down easier, and makes it more comfortable for the patient
what must you instruct the patient to do while placing an NG tube? - swallow sips of water (if permitted)
so that the tube goes down easier
what must you do once the tube is inserted all the way? - aspirate for gastric contents, and test the pH
(per hospital policy)
true or false: once you've obtained gastric content and tested the pH to confirm placement, you can start
suctioning or give feedings - false: the best way to confirm placement is by chest x-ray, so you must wait
until placement is confirmed by chest x-ray before beginning treatment
how would you know if you've placed the tube into the trachea/lungs? - the patient will be coughing
(more than normal), won't be able to breathe, may become cyanotic (blue), O2 sat will indicate
obstruction to airflow
what should you do if you accidentally place the tube in the trachea? - pull out slightly and monitor their
function to make sure they can breathe again, then try again to advance it into the stomach
why do you need to measure the external length of the tube? - so that you know if the tube has
migrated during future measurements
a pH of ____ or below indicates you are in the stomach; a pH of ___ or greater indicates you are in the
lungs; a pH of ___ indicates you are in the intestines - -5 or less for stomach (less than 4 according to the
ppt)
-6 or greater for lungs
QUESTIONS AND ANSWERS
m what are some reasons a gastric/intestinal tube might be placed? - -gut decompression
-to deliver nutrients
-empty stomach of contents, toxins, or poisons
what are some reasons a NG tube would be placed for gut decompression? - -to prevent nausea and
vomiting post-op
-for a paralytic ileus
-for GI obstruction (to suck out the obstruction)
when would an NG tube be placed to deliver nutrients? - if the patient is not able to swallow
(delivering nutrients through the GI tract if functioning is better for the body than giving it IV)
what are some various characteristics of gastric/intestinal tubes? - -gastric (stomach) vs intestinal
intubation
-large bore vs small bore
-single lumen vs double lumen
-nasally inserted vs percutaneously inserted
why might a person have an intestinal tube placed (rather than gastric)? - if a person aspirates food or is
at high risk for aspiration, the tube may be placed beyond the stomach
what type of NG tube is a double-lumen? - double lumen Salem sump tube
what are two nursing implications for NG tubes? - -make sure you understand your suction (intermittent
or continuous) and how that would affect your patient
-make sure you know how to tell if the suction works
which would be better long-term: NG tube or PEG tube? why? - PEG tubes (or PED or PEJ) are meant for
long-term use; NG tubes can cause ulcers on the nose, back of the throat, etc. so they aren't meant to be
used long-term
why might an NG tube be placed in an infant? - if they dont have an adequate suck to get enough
milk/formula; an NG tube is easily placed every time they need to feed (the babies usually swallow the
tube themselves)
what is selection of an NG tube based on? - purpose and duration of treatment
what are some steps you must take before insertion of an NG tube? - -check nostril patency
, -ask patient about medical/surgical history in relation to the nose (deviated septum, previous nasal
surgery, etc.)
-measure the tube length
how do you measure the tube length for NG tube placement? - from the nose to the ear to the xiphoid
process; mark the end with tape so you know when to stop
if placing an intestinal tube, how do you measure the length? - measure the same way for gastric
placement, then add 15-20 cm
what must you do to a double lumen feeding tube/salem sump tube before placement? - "prime the
tubing" by flushing 10 mL of warm water so that the stylet can be easily removed
when do you remove the stylet? - after placement is confirmed with a chest X-ray
when might a gastric tube be placed orally? - if the patient has a deviated septum or other nasal
condition (such as severe facial fractures) that would not allow a tube to be inserted nasally
how many times can you attempt to put in an NG tube before getting assistance? - 3 times
true or false: you must lubricate the tip before insertion - true
makes the tube go down easier, and makes it more comfortable for the patient
what must you instruct the patient to do while placing an NG tube? - swallow sips of water (if permitted)
so that the tube goes down easier
what must you do once the tube is inserted all the way? - aspirate for gastric contents, and test the pH
(per hospital policy)
true or false: once you've obtained gastric content and tested the pH to confirm placement, you can start
suctioning or give feedings - false: the best way to confirm placement is by chest x-ray, so you must wait
until placement is confirmed by chest x-ray before beginning treatment
how would you know if you've placed the tube into the trachea/lungs? - the patient will be coughing
(more than normal), won't be able to breathe, may become cyanotic (blue), O2 sat will indicate
obstruction to airflow
what should you do if you accidentally place the tube in the trachea? - pull out slightly and monitor their
function to make sure they can breathe again, then try again to advance it into the stomach
why do you need to measure the external length of the tube? - so that you know if the tube has
migrated during future measurements
a pH of ____ or below indicates you are in the stomach; a pH of ___ or greater indicates you are in the
lungs; a pH of ___ indicates you are in the intestines - -5 or less for stomach (less than 4 according to the
ppt)
-6 or greater for lungs
