exam 2 chapter 22 Flashcards Preview

Nursing 130 Perioperative > exam 2 chapter 22 > Flashcards

Flashcards in exam 2 chapter 22 Deck (70)
Loading flashcards...
1

The ability of the esophagus to transport food and fluids is facilitated by which two sphincters?

1. upper esopharyngeal (hypopharyngeal)
2. lower esopharyngeal (gastroesophageal or cardiac)
prevents reflux (backward flow) of gastric contents

2

difficult swallowing

dysphagia

3

odynophagia

acute pain on swallowing

4

Achalasia

absent or ineffective peristalsis of the distal esophagus, accompanied by failure of the sphincter to relax in response to swallowing.

5

what is the common symptom of achalasia

difficult swallowing fluids and solids.

6

Pyrosis

chest pain and heartburn.

7

How is achalasia treated

by pneumatic dilation

RN should instruct patient to eat slowly and drink fluids with meals.

8

what is a potential complication when pneumatic dilation is performed to treat achalasia?

perforation

9

what are some reasons GI intubation

decompress stomach fluid or air
lavage the stomach and remove toxins
administer medicaitons and nutrition
treat an obstruction
bypass sections of the GI tract to allow them to rest.

10

what should the suction be when a levine tube is used?

intermittent low wall suction (30 to 40 mm Hg)
To prevent gastric erosion or tearing of the stomach lining.

11

what are NG tubes such as the Levin used for?

decompression of distended stomach due to air or fluid.

12

tube feeding is also known as

enteral nutrition

13

administration of nutritionally balanced liquefied food or formule through tube inserted into stomach, deodenum or jejunum

tube feeding or enteral nutrition

14

contraindications for gastric feedings

patients at risk of aspiration
patients undergoing gastric surgery

15

A patient having a pancreatic surgery may have what type of tube?

jejunal tube to rest the pancreas by bypassing the hepatopancreatic ampulla, thereby avoiding the release of digestive enzymes into the duodenum.

16

when should feeding be started after inserting tube feeding

bowel sounds
x-ray
tube lenght from insertion site to distal end should be measured and recorded.
Tube should be marked at skin insertion site.
insertion lenght should be checked regularly.

17

tube feeding administration

HOB >30
HOB remains elevated for 30 to 60 minutes for intermittent delivery.
HOB remains semi Fowlers (45) with continuous feeding.
after feeding the HOB remains high fowlers (90) for 30-60 min.

18

Bolus feeding

resembles normal feedings pattern
300-400 formula over 30 -60 min
given every 3-6 hrs.

19

continous feeding

for 24 hours period pt remains in semi fowlers position

20

type of feeing, given over a 8-16 hr period, usually given at night to allow freedom during the day.

cyclic feeding

21

reasons for cyclic feeding

pt weaned from tube feeding to oral diet
supplements for pt who cannot eat enough.

22

position of the tube

placement checked before each feeds and medication.
every 8 hours with continuous feeds.
must be checked before administration of any contents.

23

Tube patency

continuous feedings adminstered on feeding pump with occlusion alarm.
some machines have a water bag that infuses Qhour.
bolus/cyclic irrigated with water before/after each feeding and meication administration.

24

what do you do with residual and why?

put back
to prevent F&E imbalance

25

Before feeings

aspirate gastric contents and measure amount of residual

26

general nursing consideration for tube feeding

daily weights
assess for bowel sounds before feedings
accurate I&O
initial glucose checks Q6
label with date and time started
feedings have life of 8-24 hours
pump tubing changed Q24
formula room/body temperature.

27

Tube feeding complications

vomiting
diarrhea
constipation
dehydration
aspiration
clogged tube

28

if there is asiration compications

check tube placement
check residual
elevate HOB

29

when tube is clogged

use liquid medications if possible
flush with 30-50 ml of H2O
flush with H2O Q4h for continuous feeding

Do not crush externed relase!!

30

two potential problems for tube

skin irritation
pulling out of tube