NG Tube Placement
· What is an NG tube?
· What are the 2 major actions that an NG tube facilitates?
· In what clinical situations might an NG tube be ordered?
· In what clinical situations should you question an order to place an NG tube?
· What does the order NPO indicate?
· What is the standard, evidence-based practice for verifying NG tube placement?
· What assessment(s) should you make before placing an NG tube? (measure length, assess nasal patency)
· What three points are used to measure NG tube length to be inserted?
· What position should the client be placed in for NG tube insertion?
· How should the nurse instruct the patient to help as the NG tube is inserted? (sip water and swallow)
· What item should the nurse use to ensure the NG tube is not displaced after insertion? (securement device)
· What should you document following NG tube insertion?
· What instruction should be given to the patient before the NG tube is removed? (inhale rapidly and hold your breath)
· Is NG tube placement or removal a sterile/aseptic technique?
· A client with an NG tube set to low intermittent suction is at risk for what common complication? (electrolyte disturbance/imbalance)
· Where are nutrients from enteral nutrition absorbed?
· What position should the patient be in when receiving enteral feedings?
· What actions should be taken before initiating a tube feeding?
· What is the most common complication of enteral feeding that occurs when a NG tube becomes displaced? (Aspiration)
· What kinds of tubes are used to give feeding or medication via the enteral route? (NG, OG, gastric tube, GJ tube)
· What is the most common reason for medical errors while giving medication?
· What should you do if the NG tube is currently at a different length than what was documented previously?
· How long do you need to listen for bowel sounds before concluding they are absent?
· What should you do if you assess your patient and find absent bowel sounds?
· What should you do first if your tube feeding pump is alarming?
· What should you do before and after giving any medication through an enteral tube?
· What actions should you take regarding medications to prevent tube clogging? (have the physician change orders to liquid medications whenever possible)
· Who should you call to determine if a particular medication is safe to be crushed?
· How often are residuals checked in a patient receiving enteral nutrition?
· What is refeeding syndrome? (Refeeding syndrome can happen when somebody who is malnourished begins feeding again. Causes electrolyte disturbances…especially phosphate deficiency. It’s caused by low stores of certain micronutrients in your body. Your stores are low when you have been malnourished. The most common nutrients involved are phosphorus, potassium and magnesium. When you begin refeeding, your cells demand these electrolytes to metabolize the food. This causes a severe shift in your body chemistry. The electrolytes you have move rapidly from your blood into your cells. But because you don’t have enough, this shift leaves low levels of them in your blood.)
· What should the nurse do if the client reports abdominal cramping right after tube feeding starts?
· What should you document following medication administration through an enteral tube?
· What body systems should you focus assessment on for patients receiving enteral nutrition and/or medications?
Dosage Calc Review
Converting fluid ounces to mL (or mL to fl oz)