Digestive & Gastrointestinal Treatment Modalities

"Parenteral and enteral."

"What are the two types of nutritional support?"

"Nutritional support provided through the IV route."

"What is parenteral nutrition?"

"Nutritional support provided through the gastrointestinal tract."

"What is enteral nutrition?"

"Insertion of a flexible tube into the stomach or beyond the pylorus into the duodenum or jejunum."

"What is gastrointestinal intubation?"

Into the stomach, duodenum, or jejunum.

"Where can a gastrointestinal tube be inserted?"

"To decompress the stomach."

"What is the purpose of gastrointestinal intubation in relation to stomach decompression?"

"Gas and fluid."

"What can be removed when the stomach is decompressed?"

"To wash out the stomach and remove ingested substances."

"What is gastric lavage used for?"

"Give."

"What does gavage mean?"

"Wash out or cleanse."

"What does lavage mean?"

"Toxins or other harmful materials."

"What harmful substances may be removed through gastric lavage?"

"To diagnose GI disorders."

"What is one diagnostic purpose of gastrointestinal intubation?"

Tube feedings, fluids, and medications.

"What can be administered through a gastrointestinal tube?"

"For analysis."

"Why are GI contents aspirated through a tube?"

Decompression, removal of gas/fluid, gastric lavage, removal of toxins/harmful materials, diagnosis of GI disorders, administration of feedings/fluids/medications, and aspiration of GI contents for analysis.

"What are the major purposes of gastrointestinal intubation?"

"Coughing up blood."

"What does hemoptysis mean?"

"Vomiting blood."

"What does hematemesis mean?"

"A large-bore tube inserted through the mouth into the stomach."

"What is an orogastric tube?"

"Through the mouth."

"Through what route is an orogastric tube inserted?"

"Stomach."

"Where does an orogastric tube terminate?"

"Removal of gastric contents."

"What is the purpose of the wide outlet of an orogastric tube?"

"Large bore."

"What is the bore size characteristic of an orogastric tube?"

"Babies."

"In what patients are orogastric tubes usually used according to the notes?"

"Babies are nose breathers."

"Why are orogastric tubes commonly used in babies?"

"A tube introduced through the nose into the stomach."

"What is a nasogastric tube?"

"Through the nose."

"Through what route is a nasogastric tube inserted?"

"Stomach."

"Where does a standard nasogastric tube terminate?"

Nose → ear → xiphoid process.

"What anatomical landmarks are listed for NG tube measurement in the notes?"

"A type of nasogastric tube."

"What tube is also known as a Levin tube?"

"A double-lumen tube."

"What is a Salem Sump tube?"

"It has two lumens."

"What is the main characteristic of a Salem Sump tube?"

"Gastric decompression and removal of gastric contents."

"What is a Salem Sump tube used for?"

"Compression to control bleeding."

"What is a Sengstaken-Blakemore tube used for?"

GI bleeding, particularly bleeding associated with esophageal varices.

"What type of bleeding is a Sengstaken-Blakemore tube associated with?"

Tube feedings, fluids, and medications.

"What are enteral tubes manufactured to administer?"

Length, diameter, purpose, and placement in the GI tract.

"What characteristics of enteral tubes vary?"

Rubber, polyurethane, and silicone.

"What materials can enteral tubes be made from?"

"5–12 Fr."

"What is the general bore size of enteral feeding tubes?"

"Small bore."

"Are enteral feeding tubes generally large or small bore?"

"Administration of tube feedings and medications/fluids."

"What are the two general purposes of gastric or enteric tubes?"

Nutrition, fluids, and medications.

"What is gastric or enteric feeding used to provide?"

"Gastroparesis."

"What condition involving gastric emptying is an indication for gastric or enteric feeding?"

"Severe GERD."

"What reflux condition is an indication for gastric or enteric feeding?"

"Impaired glottic closure."

"What airway-protection problem is an indication for gastric or enteric feeding?"

"Partial or total gastrectomy."

"What type of gastrectomy may indicate gastric or enteric feeding?"

"Risk for aspiration."

"What aspiration-related condition is an indication for gastric or enteric feeding?"

Gastroparesis, severe GERD, impaired glottic closure, partial or total gastrectomy, and risk for aspiration.

"What are the indications for gastric or enteric feeding listed in the notes?"

"Through the nose."

"What is the route of insertion for a nasogastric feeding tube?"

"Into the stomach and beyond the pylorus into the small intestine."

"Where can a nasogastric feeding tube extend?"

"A tube inserted from the mouth to the small intestine."

"What is an oroenteric tube?"

"Through the mouth."

"Through what route is an oroenteric tube inserted?"

"Small intestine."

"Where does an oroenteric tube terminate?"

"An enteric tube placed in the duodenum via the nares."

"What is a nasoduodenal tube?"

"Through the nares."

"Through what route is a nasoduodenal tube inserted?"

"Duodenum."

"Where does a nasoduodenal tube terminate?"

"An enteric tube placed in the jejunum via the nares."

"What is a nasojejunal tube?"

"Through the nares."

"Through what route is a nasojejunal tube inserted?"

"Jejunum."

"Where does a nasojejunal tube terminate?"

A nasoduodenal tube terminates in the duodenum, while a nasojejunal tube terminates in the jejunum.

"What is the difference between a nasoduodenal and nasojejunal tube?"

An orogastric tube enters the stomach, while an oroenteric tube extends to the small intestine.

"What is the difference between an orogastric and oroenteric tube?"

A nasogastric tube terminates in the stomach, while a nasoenteric tube extends beyond the pylorus into the small intestine.

"What is the difference between a nasogastric and nasoenteric tube?"

"Nasoduodenal and nasojejunal tubes."

"What are the enteric tube types specifically listed in the notes?"

At the bedside, during surgery, fluoroscopically, or endoscopically.

"Where can nasoduodenal and nasojejunal tubes be inserted?"

Bedside, surgical, fluoroscopic, and endoscopic placement

"What are the four methods of enteric tube placement?"

"Physicians and advanced practice clinicians."

"Who can insert enteric tubes according to the notes?"

"Yes."

"Can enteric tubes be inserted at the bedside?"

"Yes."

"Can enteric tubes be inserted during surgery?"

"Yes."

"Can enteric tubes be inserted fluoroscopically?"

"Yes."

"Can enteric tubes be inserted endoscopically?"

"Basilar skull fracture."

"In what skull injury should enteric tubes never be inserted?"

"Maxillofacial surgery."

"What type of surgery is a contraindication to enteric tube insertion?"

"Facial trauma."

"What type of facial injury is a contraindication to enteric tube insertion?"

"Uncontrolled coagulation abnormalities."

"What coagulation problem is a contraindication to enteric tube insertion?"

"Esophageal varices."

"What esophageal condition is a contraindication to enteric tube insertion?"

Basilar skull fracture, maxillofacial surgery, facial trauma, uncontrolled coagulation abnormalities, and esophageal varices.

"What are the contraindications to enteric tube insertion listed in the notes?"

"It is a contraindication to enteric tube insertion."

"Why is a basilar skull fracture important when considering enteric tube insertion?"

"Heparin."

"What medication is mentioned in the notes in relation to blood clotting?"

"To prevent blood clotting or formation of blood clots."

"What is the purpose of heparin?"

"Cortrak enteral access system."

"What enteral access system is mentioned in the notes?"

"Synchro Blue tube."

"What tube is mentioned with the Cortrak enteral access system?"

"Possible tube obstruction."

"What should be considered when a feeding tube is difficult to instill or withdraw contents from?"

"Warm water irrigation."

"What is the first listed method for clearing a feeding tube obstruction?"

"Warm water."

"What type of water is used for irrigation when clearing a tube obstruction?"

"Milking the tube."

"What manual technique can be used to clear a feeding tube obstruction?"

"Digestive enzymes."

"What can be infused to help clear a feeding tube obstruction?"

"Mechanical declogging devices."

"What type of devices can be used for mechanical tube declogging?"

Warm water irrigation.

"What are the four listed methods for clearing a feeding tube obstruction?"

"When it is difficult to instill or withdraw contents from the feeding tube."

"When should tube obstruction-clearing measures be considered?"

"All fluid intake."

"What must the nurse accurately record in a patient receiving enteral feeding?"

"Feeding volumes."

"What feeding-related information must the nurse record?"

"Irrigation volumes."

"What irrigation-related information must the nurse record?"

Feeding volumes.

"What is the purpose of accurately recording intake

"By irrigating the tube with water after every feeding."

"How is feeding tube patency maintained?"

"After every feeding."

"When should a feeding tube be irrigated with water to maintain patency?"

"To maintain tube patency."

"What is the main purpose of water irrigation after feeding?"

Accurately record fluid intake, feedings, and irrigation volumes and irrigate the tube with water after every feeding.

"What are the main nursing responsibilities for maintaining tube function?"

Orogastric, nasogastric, gastric feeding, oroenteric, nasoduodenal, and nasojejunal tubes.

"What are the main tube categories discussed in the notes?"

"Orogastric tube."

"Which tube is large bore and inserted through the mouth into the stomach?"

"Nasogastric tube."

"Which tube is introduced through the nose into the stomach?"

"Salem Sump."

"Which tube is double lumen?"