NSG-320 Exam 3 UPDATED QUESTIONS
AND CORRECT ANSWERS
Enteral nutrition - CORRECT ANSWER -Also called tube feeding
-The administration of nutritionally balanced liquefied food through a tube inserted into the
stomach, duodenum, or jejunum
-Used with the patient who has a functioning GI tract but is unable to take any or enough oral
nourishment, or when it is unsafe to do so
-Feedings can be started when bowel sounds are present, usually 24 hours after placement
Indications include those with:
-Any condition that impacts ability to safely swallow
-Anorexia
-Facial features
-Head/neck cancer
-Neurologic or psychiatric conditions
-Extensive burns
-Critical illness
-Chemotherapy
-Radiation therapy
-Stroke
Delivery options include:
-Continuous infusion by pump
-Cyclic feedings by pump
-Intermittent by gravity
-Intermittent bolus by syringe
-Critically ill patients often receive it through continuous infusion
-Intermittent feeding may be preferred as the patient improves or is receiving EN at home
,Aspiration Risk:
-Ensure proper position of tube
-Maintain head-of-bed elevation
-Check gastric residual volume
Client Position:
-Patient should be sitting or lying with HOB at 30 to 45 degrees
-HOB remains elevated for 30 to 60 minutes for intermittent delivery
-Proper patient positioning decreases the risk of aspiration.
-If you need to lower the head of bed for a procedure, return the patient to an elevated
position as soon as possible.
-Follow institution policy for suspending feeding while the patient is supine.
Tube Position:
-X-ray confirmation for new nasal or orogastric tubes
-To determine if a feeding tube has maintained proper position, mark the exit site of the
feeding tube at the time of the initial x-ray, and observe for a change in the external tube
length during feedings
-Check placement before each feeding/drug administration or every 8 hours with continuous
feeds
-Check insertion length regularl
Polyurethane or silicone tube - CORRECT ANSWER -Soft, long, small in diameter,
and flexible, decreasing the risk of mucosal damage from prolonged placement
-Radiopaque
-Placement in small intestine decreases the chance of regurgitating gastric contents into the
esophagus and subsequent aspiration. However, the patient can still aspirate gastric secretions
if the stomach is not emptying properly
-Stylet may be used for placement in a comatose patient because the ability to swallow is not
essential during insertion. A complication that can result from using a stylet is increased risk
for perforation.
-Decreased likelihood of regurgitation and aspiration when placed in the intestine
,Nasogastric and nasointestinal tubes - CORRECT ANSWER -Can clog easily when the
feedings are thick because of their small diameter
-More difficult to use for checking residual volumes
-Partially prone to obstruction when oral drugs have not been thoroughly crushed and
dissolved in water before administration
-Failure to flush the tubing after both drug administration and residual volume determinations
can result in tube clogging
-Can be dislodged by vomiting or coughing
-Can be knotted/kinked in GI tract
-Problems with a tube may necessitate removal and insertion of a new tube, which adds to
cost and patient discomfort
Gastrostomy and jejunostomy tubes - CORRECT ANSWER -May be used when a
patient requires tube feedings for an extended time
-Patient must have intact, unobstructed GI tract
-Can be placed surgically, radiologically, or endoscopically
-The esophageal lumen must be wide enough to pass the endoscope for percutaneous
endoscopic gastrostomy (PEG) tube placement
Two Potential Problems:
-Skin irritation: skin assessment and care
-Pulling out of tube: teach patient/family about feeding administration, tube care, and
complications
Percutaneous endoscopic gastrostomy - CORRECT ANSWER -Gastrostomy tube
placement via percutaneous endoscopy
-Using endoscopy, a gastrostomy tube is inserted through the esophagus into the stomach and
then is pulled through a stab wound made in the abdominal wall
-Requires esophageal lumen wide enough for endoscope.
-Because they require no general anesthesia and only minimum or no sedation of the patient,
these techniques can be done at a lower cost.
, -PEG tube and radiologically placed gastrostomy tube procedures have fewer risks than
surgical placement. The procedure requires IV sedation and local anesthesia. IV antibiotics
are given before the procedure.
-Most PEG tube feedings can start within 2 hours of insertion
Parenteral nutrition - CORRECT ANSWER -Administration of nutrients directly into
the bloodstream
-Goal: meet nutritional needs and allow growth of new body tissue
-Customized to meet each patient's needs
Common Indications:
-Chronic severe diarrhea and vomiting
-Complicated surgery or trauma
-GI obstruction
-Intractable diarrhea
-Severe anorexia nervosa
-Severe malabsorption
-Short bowel syndrome
-GI tract anomalies and fistulae
-Normal adult requires minimum 1200 to 1500 calories/day.
-Patients who sustain severe injury, surgery, or burns and those who are malnourished as a
result of medical treatment or disease processes have greatly increased nutritional needs.
-Used when GI tract cannot be used for ingestion, digestion, and absorption of essential
nutrients.
Composition:
-Base solutions contain dextrose and protein in the form of amino acids
-Prescribed electrolytes, vitamins, and trace elements are added to customize and meet the
needs of each client
-Reformulated as the patient's condition changes
-IV fat emulsion is added to complete the nutrients
AND CORRECT ANSWERS
Enteral nutrition - CORRECT ANSWER -Also called tube feeding
-The administration of nutritionally balanced liquefied food through a tube inserted into the
stomach, duodenum, or jejunum
-Used with the patient who has a functioning GI tract but is unable to take any or enough oral
nourishment, or when it is unsafe to do so
-Feedings can be started when bowel sounds are present, usually 24 hours after placement
Indications include those with:
-Any condition that impacts ability to safely swallow
-Anorexia
-Facial features
-Head/neck cancer
-Neurologic or psychiatric conditions
-Extensive burns
-Critical illness
-Chemotherapy
-Radiation therapy
-Stroke
Delivery options include:
-Continuous infusion by pump
-Cyclic feedings by pump
-Intermittent by gravity
-Intermittent bolus by syringe
-Critically ill patients often receive it through continuous infusion
-Intermittent feeding may be preferred as the patient improves or is receiving EN at home
,Aspiration Risk:
-Ensure proper position of tube
-Maintain head-of-bed elevation
-Check gastric residual volume
Client Position:
-Patient should be sitting or lying with HOB at 30 to 45 degrees
-HOB remains elevated for 30 to 60 minutes for intermittent delivery
-Proper patient positioning decreases the risk of aspiration.
-If you need to lower the head of bed for a procedure, return the patient to an elevated
position as soon as possible.
-Follow institution policy for suspending feeding while the patient is supine.
Tube Position:
-X-ray confirmation for new nasal or orogastric tubes
-To determine if a feeding tube has maintained proper position, mark the exit site of the
feeding tube at the time of the initial x-ray, and observe for a change in the external tube
length during feedings
-Check placement before each feeding/drug administration or every 8 hours with continuous
feeds
-Check insertion length regularl
Polyurethane or silicone tube - CORRECT ANSWER -Soft, long, small in diameter,
and flexible, decreasing the risk of mucosal damage from prolonged placement
-Radiopaque
-Placement in small intestine decreases the chance of regurgitating gastric contents into the
esophagus and subsequent aspiration. However, the patient can still aspirate gastric secretions
if the stomach is not emptying properly
-Stylet may be used for placement in a comatose patient because the ability to swallow is not
essential during insertion. A complication that can result from using a stylet is increased risk
for perforation.
-Decreased likelihood of regurgitation and aspiration when placed in the intestine
,Nasogastric and nasointestinal tubes - CORRECT ANSWER -Can clog easily when the
feedings are thick because of their small diameter
-More difficult to use for checking residual volumes
-Partially prone to obstruction when oral drugs have not been thoroughly crushed and
dissolved in water before administration
-Failure to flush the tubing after both drug administration and residual volume determinations
can result in tube clogging
-Can be dislodged by vomiting or coughing
-Can be knotted/kinked in GI tract
-Problems with a tube may necessitate removal and insertion of a new tube, which adds to
cost and patient discomfort
Gastrostomy and jejunostomy tubes - CORRECT ANSWER -May be used when a
patient requires tube feedings for an extended time
-Patient must have intact, unobstructed GI tract
-Can be placed surgically, radiologically, or endoscopically
-The esophageal lumen must be wide enough to pass the endoscope for percutaneous
endoscopic gastrostomy (PEG) tube placement
Two Potential Problems:
-Skin irritation: skin assessment and care
-Pulling out of tube: teach patient/family about feeding administration, tube care, and
complications
Percutaneous endoscopic gastrostomy - CORRECT ANSWER -Gastrostomy tube
placement via percutaneous endoscopy
-Using endoscopy, a gastrostomy tube is inserted through the esophagus into the stomach and
then is pulled through a stab wound made in the abdominal wall
-Requires esophageal lumen wide enough for endoscope.
-Because they require no general anesthesia and only minimum or no sedation of the patient,
these techniques can be done at a lower cost.
, -PEG tube and radiologically placed gastrostomy tube procedures have fewer risks than
surgical placement. The procedure requires IV sedation and local anesthesia. IV antibiotics
are given before the procedure.
-Most PEG tube feedings can start within 2 hours of insertion
Parenteral nutrition - CORRECT ANSWER -Administration of nutrients directly into
the bloodstream
-Goal: meet nutritional needs and allow growth of new body tissue
-Customized to meet each patient's needs
Common Indications:
-Chronic severe diarrhea and vomiting
-Complicated surgery or trauma
-GI obstruction
-Intractable diarrhea
-Severe anorexia nervosa
-Severe malabsorption
-Short bowel syndrome
-GI tract anomalies and fistulae
-Normal adult requires minimum 1200 to 1500 calories/day.
-Patients who sustain severe injury, surgery, or burns and those who are malnourished as a
result of medical treatment or disease processes have greatly increased nutritional needs.
-Used when GI tract cannot be used for ingestion, digestion, and absorption of essential
nutrients.
Composition:
-Base solutions contain dextrose and protein in the form of amino acids
-Prescribed electrolytes, vitamins, and trace elements are added to customize and meet the
needs of each client
-Reformulated as the patient's condition changes
-IV fat emulsion is added to complete the nutrients
