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Week 7 Lesson 2 NCO
Week 7 NCO Insering a Small Bore Nasogastric or Nasoenteric Feeding tube
| Question | Answer |
|---|---|
| The patient is recovering from a severe stroke. He is receiving enteral feedings. Last evening he pulled out the feeding tube and it must be replaced. It is appropriate to have an NAP insert the tube. | False : This skill requires the critical thinking and knowledge application unique to a nurse and therefore is inappropriate to delegate to NAP. |
| If the NAP reports that the patient is coughing and seems to be having more difficulty breathing, it could be an indication the NG feeding tube has become displaced. | True : If a patient’s respirations change or a patient complains of shortness of breath, coughing, or choking, this could be an indication the NG feeding tube has migrated and is no longer in its intended location of the stomach. |
| The nurse should check the patient’s lab results regarding coagulation studies before inserting an NG tube. | True : All candidates for NG tube or nasoenteric placement require an assessment of their coagulation status. |
| You have received an order to insert an NG feeding tube and to begin tube feedings once placement has been verified. Which of the following may contraindicate NG tube insertion and feeding at this time? (Select all that apply.) | 1. Absence of bowel naris; slight edema of mucosa of left naris2. 2. On anticouagulant therapy with recent nosebleed |
| The nurse has received an order to insert a nasogastric feeding tube. The nurse should start with the selection of a 12-French nasogastric feeding tube to enhance patient comfort. | False: The nurse should select the smallest diameter possible to enhance patient comfort. An 8-French tube has a smaller diameter than a 12-French tube. |
| Sterile gloves are not required for inserting a nasoenteric feeding tube. | True: Clean gloves are used for inserting a nasoenteric or nasogastric feeding tube |
| The patient is recovering from a motor vehicle accident. He has been too weak and his appetite too poor to consume enough calories to aid his healing. Because the patient has a functioning GI tract, the health care provider has ordered an NG feeding tube | 1. The tube is placed in the stomach. 2. The nasal mucosa remains pink without irritation, |
| You are inserting an NG tube when the patient begins to choke and turn blue. What is your next best action? | Withdraw the tube into the posterior nasopharynx until normal breathing resumes, then try to advance the tube once more. |
| The nurse inserted an NI feeding tube. Which documentation made by the nurse after completion of the procedure indicates that the expected outcomes were met? | Number 10 French small bore feeding tube inserted into right naris, advanced approximately 60 cm. Patient experienced slight discomfort without gagging or vomiting. chest x-ray fil confirmed duodenal placement. Intestinal aspirate tested at pH 7.0 bile |
| The nurse has inserted an NG feeding tube. Which of the following actions should be included in the nurse's evaluation of the procedure? (Select all that apply.) | 1. Auscultation of lung sounds 2. Confirming x-ray results with health care provider 3. Inspecting nasal mucosa 4. Observing patient for persistent gagging or coughing |
| As you are inserting the feeding tube, resistance is felt and the patient begins to cough. What action should you take? | Stop advancing the tube and pull the tube back into the posterior nasopharynx until normal breathing resumes |
| You are inserting the NG feeding tube. What actions, if made during the procedure, requires correction? (Select all that apply.) | 1. To increase patient comfort, you place the feeding tube in ice before insertion. 2. You tape the tube in place after x-ray verification of proper placement. 3. You leave the guidewire in place at all times. |
| The radiologist calls stating that the end of the patient's feeding tube is in the esophagus and the tube should be advanced approximately 7.5 cm to reach the stomach. You return to the patient's room and find that the stylet has already been removed. Wha | Remove the tape, advance the tube the desired amount, and have another x-ray image. |
| For intestinal placement of a feeding tube, in what position should the nurse place the patient while waiting for radiological confirmation of correct placement? | On the patient's right side |
| The nurse is inserting an NG feeding tube for the first time. Which action, if made by the nurse, indicates further instruction is needed? | The nurse has the patient flex the head as the tube is inserted into the naris. |
| The patient begins to cough and choke as the nurse is inserting the NG tube. What is the best action for the nurse to take at this time? | Pull the tube back into the posterior nasopharynx and attempt to reinsert. |
| The patient’s wife is watching as the nurse prepares to insert a small bore feeding tube. She asks the nurse, "What is the purpose of the guide wire?" The nurse correctly responds: | "Because feeding tubes are flexible, a guide wire or stylet is used to provide rigidity that facilitates positioning." |
| You have inserted an NG feeding tube. The patient vomited during insertion and continues to gag. What action(s) should you take? (Select all that apply.) | 1. Suction airway as needed 2. Position patient on side 3. Contact health care provider for possible chest x-ray |
| The health care provider just left the patient’s room after explaining the options of NG or NI feeding tube placement. A student asks a nurse about the differences between nasogastric and nasointestinal feedings. Which of the following are accurate statem | 1. Gastric aspirate is expected to have a lower pH than intestinal aspirate. 2. The advantage to an NI tube is that there is less risk for aspiration. 3. Both NG and NI tubes are usually for less than 30 days. |
Created by:
Brandi Sizemore
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