Nursing Skills Exam- Enteral Tube Feeds
(TPN) Questions Fully Solved .
Parenteral Nutrition (PN) - Answer - the intravenous infusion of nutrients administered directly
into the bloodstream, bypassing the digestive system (through the central vein)
Enteral nutrition (EN) - Answer - Provided when pt is unable to digest foods or the upper GI
tract is impaired and the transport of food to the small intestine is interrupted
- Can also be used to supplement the client's own food intake when it is insufficient to meet
daily needs
- Administered though NG tube and small bore feeding tubes or through gastrostomy or
jejunostomy tubes
Nasogastric tube - Answer - Inserted through one of the nostrils, down the nasopharynx, and
into the alimentary tract
- In some instances the tube is passed through the mouth and pharynx although this route is
more uncomfortable for the adult client and cause gagging
- This approach is used for infants who are only able to breathe through their nose and
premature infants who have no gag reflex
Large-bore nasogastric tubes - Answer - Larger than 12 FR in diameter
- Placed in stomach
- Ex: Levin tube and Salem sump tube
Levin tube - Answer - a flexible rubber or plastic, single-lumen tube with holes near the tip
Salem sump tube - Answer - double lumen
- allows delivery of liquids to the stomach or removal of gastric contents
- only one that suctions
- when it is used for suction of gastric contents, the smaller vent lumen (proximal port is often
referred to as the blue pigtail) allows for an inflow of atmospheric air which prevents a vacuum
if the gastric tube adheres to the wall of the stomach
- Irritation go the gastric muscle is thereby avoided
, Reasons for using NG tube - Answer - to prevent nausea, vomiting and gastric distention
following surgery (tube is attached to suction source)
- to remove stomach contents for lab analysis
- to wash the stomach in cases of poisoning or overdose of medications
nasoenteric tube - Answer - longer tube than NG tube (at least 40cm for adult)
- inserted through one nostril down into the supper small intestine
When are nasoenteric tubes used? - Answer - for clients at risk for aspiration
Patients at risk for aspiration manifestations - Answer - decreased LOC
- poor/absent cough or gag reflexes
- endotracheal intubation
- recent extubation
- inability to cooperate with the procedure
- restlessness or agitation
Gastrostomy - Answer - used for long term nutritional support (more than 6-8 weeks)
- tubes are placed surgically through abdominal wall into the stomach
Jejunostomy - Answer - used for long term nutritional support (more than 6-8 weeks)
- tubes are placed surgically into the jejunum
percutaneous endoscopic gastrostomy (PEG) - Answer - created by using an endoscope to
visualize the inside of the stomach, making a puncture through the skin and subcutaneous
tissues of the abdomen into the stomach and inserting the PEG catheter through the puncture
- surgical opening is sutured tightly around the tube or catheter to prevent leakage
- care of this opening before it heals requires asepsis
- catheter has an external bumper and an internal inflatable retention balloon to maintain
placement
- when the tract is established (about 1 month), the tube or catheter can be removed and
reinserted for each feeding
(TPN) Questions Fully Solved .
Parenteral Nutrition (PN) - Answer - the intravenous infusion of nutrients administered directly
into the bloodstream, bypassing the digestive system (through the central vein)
Enteral nutrition (EN) - Answer - Provided when pt is unable to digest foods or the upper GI
tract is impaired and the transport of food to the small intestine is interrupted
- Can also be used to supplement the client's own food intake when it is insufficient to meet
daily needs
- Administered though NG tube and small bore feeding tubes or through gastrostomy or
jejunostomy tubes
Nasogastric tube - Answer - Inserted through one of the nostrils, down the nasopharynx, and
into the alimentary tract
- In some instances the tube is passed through the mouth and pharynx although this route is
more uncomfortable for the adult client and cause gagging
- This approach is used for infants who are only able to breathe through their nose and
premature infants who have no gag reflex
Large-bore nasogastric tubes - Answer - Larger than 12 FR in diameter
- Placed in stomach
- Ex: Levin tube and Salem sump tube
Levin tube - Answer - a flexible rubber or plastic, single-lumen tube with holes near the tip
Salem sump tube - Answer - double lumen
- allows delivery of liquids to the stomach or removal of gastric contents
- only one that suctions
- when it is used for suction of gastric contents, the smaller vent lumen (proximal port is often
referred to as the blue pigtail) allows for an inflow of atmospheric air which prevents a vacuum
if the gastric tube adheres to the wall of the stomach
- Irritation go the gastric muscle is thereby avoided
, Reasons for using NG tube - Answer - to prevent nausea, vomiting and gastric distention
following surgery (tube is attached to suction source)
- to remove stomach contents for lab analysis
- to wash the stomach in cases of poisoning or overdose of medications
nasoenteric tube - Answer - longer tube than NG tube (at least 40cm for adult)
- inserted through one nostril down into the supper small intestine
When are nasoenteric tubes used? - Answer - for clients at risk for aspiration
Patients at risk for aspiration manifestations - Answer - decreased LOC
- poor/absent cough or gag reflexes
- endotracheal intubation
- recent extubation
- inability to cooperate with the procedure
- restlessness or agitation
Gastrostomy - Answer - used for long term nutritional support (more than 6-8 weeks)
- tubes are placed surgically through abdominal wall into the stomach
Jejunostomy - Answer - used for long term nutritional support (more than 6-8 weeks)
- tubes are placed surgically into the jejunum
percutaneous endoscopic gastrostomy (PEG) - Answer - created by using an endoscope to
visualize the inside of the stomach, making a puncture through the skin and subcutaneous
tissues of the abdomen into the stomach and inserting the PEG catheter through the puncture
- surgical opening is sutured tightly around the tube or catheter to prevent leakage
- care of this opening before it heals requires asepsis
- catheter has an external bumper and an internal inflatable retention balloon to maintain
placement
- when the tract is established (about 1 month), the tube or catheter can be removed and
reinserted for each feeding
