NURS 3160 MIDTERM 1
What is the main condition for Enteral nutrition? - CORRECT ANSWER -The client MUST
have a functioning GI system.
What are the main indications for enteral nutrition tubes? - CORRECT ANSWER --clients
that can not eat (surgery, intubated etc)
- clients with nutritional deficit
- clients with impaired swallowing/gag reflex
- Gastric decompression
What are examples of long term tubes? - CORRECT ANSWER -Gastrostomy or jejunostomy
tubes
What size would you expect a large/small bore tube to be? - CORRECT ANSWER -lg- >12
french
sm- 8-12 french
How long does a short term tube usually stay in? - CORRECT ANSWER -4-6 weeks
T/F
Salem Sump can be on continuous suction. - CORRECT ANSWER -TRUE, when used for
gastric decompression
T/F Enteriflex can only be used for gastric decompression - CORRECT ANSWER -FALSE!!
Enteriflex is used for feeding only! ( small bore tube) Salem Sump is used for decompression
,What are common uses for large bore tubes, and what are they? - CORRECT ANSWER -
Salem Sump/Levin
used for short term feeding, and gastric decompression.
Which size tube has an increased risk for aspiration, tube migration and misplacement? -
CORRECT ANSWER -Large bore tubes
What is the main benefit of small bore tubes? - CORRECT ANSWER -comfortable and
reduce gastric erosion. Also less aspiration risk or migration
What are the risks associated with small bore tubes? - CORRECT ANSWER -easily occulded,
and can not be aspirated.
What is the most common small bore tube? - CORRECT ANSWER -Enteriflex
Which tube has a wire in-situ, and a weighted metal tip to be verified on x-ray? - CORRECT
ANSWER -enteriflex
What are the surgically inserted vs. endoscopically inserted tubes? - CORRECT ANSWER -sx-
gastrostomy, jejunostomy
Endo- PEG, PEJ, GJ
What are the indications for long term tubes? - CORRECT ANSWER -Long term feeding (
months- years)
aspiration risk
hx of aspiration
pneumonia
gastroparesis
,Why would a GJ tube have two ports? - CORRECT ANSWER -One port in the stomach for
decompression and another for medication/feed
Why would you use a GJ tube over others? - CORRECT ANSWER -Dysmotility, aspiration
risk, frequent vomiting.
Which feed schedule requires the use of a pump? - CORRECT ANSWER -Continuous feeds.
*** I feel like we use pumps for all..but this was in the slides**
How long can feeding systems be open? - CORRECT ANSWER -Open- max 4 hours
Closed- max 48hrs ( usually finished within 24)
What are the 4 steps when assessing tube placement? - CORRECT ANSWER -- assess for s/s
of aspiration/migration
- check marker at nares
- measure external length
- check pH ( if needed)
T/F
GVR is only checked with large bore tubes? - CORRECT ANSWER -TRUE!
not checked for small bore or post pyloric tubes. Also not checked if client is taking anything
PO
Which of the following situations would you need to pause a tube feed? SATA
a. medication admin
b. personal care
c. SOB/ diaphoretic
d. lowering HOB - CORRECT ANSWER -abcd
, T/F
When flushing a feeding tube you need to use sterile water? - CORRECT ANSWER -TRICK!!!
Follow agency policy ( but usually tap water is fine :) )
When you come on shift you notice your client has a NG tube and when giving meds you see
prescribed Esomeprazole 40 mg tab, and ramipril 10mg. What is your next action?
a. crush both meds, mix with warm water and give individually
b. call pharmacy as these medications can not be given via NG tube.
c. dissolve esomeprazole, and crush ramipril
d. dissolve esomeprazole and open ramipril - CORRECT ANSWER -d
You are caring for a client who has been receiving continuous EN for 3 days and has not had
a bowel movement since the feeds began. They now have mild lower abdominal pain. What
is your priority action? - CORRECT ANSWER -Assess clients abdomen, and PQRSTU
What is refeeding syndrome? - CORRECT ANSWER -hypokalemia, hypomagnesemia, and
hypophosphatemia after refeeding a starved patient
What are the s/s of refeeding syndrome? - CORRECT ANSWER -peripheral edema
arrythmias
cardiac arrest
seizures
delirium
hypotension
What are major risk factors for refeeding syndrome? - CORRECT ANSWER -ONE or more of:
BMI <16, weight loss of 15% in 3-6 months.
No nutrient intake for 10 days
pre-existing hypo K, mg, Pho
What is the main condition for Enteral nutrition? - CORRECT ANSWER -The client MUST
have a functioning GI system.
What are the main indications for enteral nutrition tubes? - CORRECT ANSWER --clients
that can not eat (surgery, intubated etc)
- clients with nutritional deficit
- clients with impaired swallowing/gag reflex
- Gastric decompression
What are examples of long term tubes? - CORRECT ANSWER -Gastrostomy or jejunostomy
tubes
What size would you expect a large/small bore tube to be? - CORRECT ANSWER -lg- >12
french
sm- 8-12 french
How long does a short term tube usually stay in? - CORRECT ANSWER -4-6 weeks
T/F
Salem Sump can be on continuous suction. - CORRECT ANSWER -TRUE, when used for
gastric decompression
T/F Enteriflex can only be used for gastric decompression - CORRECT ANSWER -FALSE!!
Enteriflex is used for feeding only! ( small bore tube) Salem Sump is used for decompression
,What are common uses for large bore tubes, and what are they? - CORRECT ANSWER -
Salem Sump/Levin
used for short term feeding, and gastric decompression.
Which size tube has an increased risk for aspiration, tube migration and misplacement? -
CORRECT ANSWER -Large bore tubes
What is the main benefit of small bore tubes? - CORRECT ANSWER -comfortable and
reduce gastric erosion. Also less aspiration risk or migration
What are the risks associated with small bore tubes? - CORRECT ANSWER -easily occulded,
and can not be aspirated.
What is the most common small bore tube? - CORRECT ANSWER -Enteriflex
Which tube has a wire in-situ, and a weighted metal tip to be verified on x-ray? - CORRECT
ANSWER -enteriflex
What are the surgically inserted vs. endoscopically inserted tubes? - CORRECT ANSWER -sx-
gastrostomy, jejunostomy
Endo- PEG, PEJ, GJ
What are the indications for long term tubes? - CORRECT ANSWER -Long term feeding (
months- years)
aspiration risk
hx of aspiration
pneumonia
gastroparesis
,Why would a GJ tube have two ports? - CORRECT ANSWER -One port in the stomach for
decompression and another for medication/feed
Why would you use a GJ tube over others? - CORRECT ANSWER -Dysmotility, aspiration
risk, frequent vomiting.
Which feed schedule requires the use of a pump? - CORRECT ANSWER -Continuous feeds.
*** I feel like we use pumps for all..but this was in the slides**
How long can feeding systems be open? - CORRECT ANSWER -Open- max 4 hours
Closed- max 48hrs ( usually finished within 24)
What are the 4 steps when assessing tube placement? - CORRECT ANSWER -- assess for s/s
of aspiration/migration
- check marker at nares
- measure external length
- check pH ( if needed)
T/F
GVR is only checked with large bore tubes? - CORRECT ANSWER -TRUE!
not checked for small bore or post pyloric tubes. Also not checked if client is taking anything
PO
Which of the following situations would you need to pause a tube feed? SATA
a. medication admin
b. personal care
c. SOB/ diaphoretic
d. lowering HOB - CORRECT ANSWER -abcd
, T/F
When flushing a feeding tube you need to use sterile water? - CORRECT ANSWER -TRICK!!!
Follow agency policy ( but usually tap water is fine :) )
When you come on shift you notice your client has a NG tube and when giving meds you see
prescribed Esomeprazole 40 mg tab, and ramipril 10mg. What is your next action?
a. crush both meds, mix with warm water and give individually
b. call pharmacy as these medications can not be given via NG tube.
c. dissolve esomeprazole, and crush ramipril
d. dissolve esomeprazole and open ramipril - CORRECT ANSWER -d
You are caring for a client who has been receiving continuous EN for 3 days and has not had
a bowel movement since the feeds began. They now have mild lower abdominal pain. What
is your priority action? - CORRECT ANSWER -Assess clients abdomen, and PQRSTU
What is refeeding syndrome? - CORRECT ANSWER -hypokalemia, hypomagnesemia, and
hypophosphatemia after refeeding a starved patient
What are the s/s of refeeding syndrome? - CORRECT ANSWER -peripheral edema
arrythmias
cardiac arrest
seizures
delirium
hypotension
What are major risk factors for refeeding syndrome? - CORRECT ANSWER -ONE or more of:
BMI <16, weight loss of 15% in 3-6 months.
No nutrient intake for 10 days
pre-existing hypo K, mg, Pho
