Nursing Exam 2 Study Guide Vocabulary

Ch. 49 - Fecal Elimination

• Defecations is the process of elimination of waste from the digestive system

  • Feces or stool

• Feces

  • Cases distention of rectum

  • Stimulates distention of receptors

  • The sitting position increases the downward pressure on the rectum, making it easier to pass stool

• Characteristics of Feces

  • Normal

    • Color

      • Adult: brown

      • Infant: yellow

    • Consistency

      • Formed, soft, semisolid, moist

    • Shape

      • Cylindrical (contour of rectum) about 2.5 cm (1 in.) in diameter in adults

    • Amount

      • Varies with diet (about 100-400 g/day)

    • Odor

      • Aromatic; affected by ingested food and individual’s own bacterial flora

    • Constituents

      • Small amounts of undigested roughage, sloughed dead bacteria and epithelial cells, fat, protein, dried constituents of digestive juices (e.g., bile pigments, inorganic matter)

  • Abnormal

    • Color

      • Clay or white

        • Absence bile pigment (bile obstruction); diagnostic study using barium

      • Black or tarry

        • Drug (e.g., iron); bleeding from upper gi track (e.g., stomach and small intestine); diet high in rich meat and dark green vegetables (e.g., spinach)

      • Red

        • Bleeding from lower gi tract (e.g., rectum); some foods (e.g., beets) *Other causes of red: Hemorrhoids Coumadin Cancer

      • Pale

        • Malabsorption of fats; diet high in milk and milk products and low in meat

      • Orange or green

        • Intestinal infection

    • Consistency

      • Hard, dry

        • Dehydration; decreased intestinal motility resulting from lack of fiber in diet, lack of exercise, emotional upset, laxative abuse

    • Shape

      • Narrow, pencil-shaped, or string like stool

        • Obstructive condition of the rectum

    • Odor

      • Pungent

        • Infection, blood

    • Constituents

      • Pus

        • Bacterial infection

      • Parasites

        • Inflammatory condition

      • Blood

        • GI bleeding

      • Mucus

        • Malabsorption

      • Large quantities of fat

        • Accidental ingestion

      • Foreign objects

        • Malabsorption

• Factors Affecting Bowel Elimination

  • Developmental

    • Newborns & infants

    • Toddlers

    • School-age Children & Adolescents

    • Older adults

  • Diet

    • Fiber is necessary for fecal volume

    • Soluble Fiber

      • Dissolves in water to form a gel-like material

      • Oats, peas, beans, apples, citrus fruits, barley

    • Insoluble Fiber

      • Promotes movement of material through digestive system & increases stool bulk

      • Wheat flower, wheat bran, nuts and vegetables

  • Activity

  • Psychological

  • Defecation habits

  • Medications

    • Laxitives

  • Diagnostic procedures

  • Anesthesia and Surgery

  • Pathological conditions

  • Pain

• Constipation: decreased frequency of defection. Hard, dry, formed stools

  • Constipation is defined as fewer than three bowel movement per week

  • Causes:

    • Insufficient fiber intake

    • Insufficient fluid intake

    • Insufficient activity or immobility

    • Irregular defecation habits

    • Change in daily routine

    • Lack of privacy

    • Chronic use of laxatives or enemas

    • Irritable bowel syndrome (IBS)

    • Pelvic floor dysfunction or muscle damage

    • Poor motility or slow transit

    • Neurologic conditions (e.g., Parkinson’s disease), stroke, or paralysis

    • Emotional disturbances such as depression or mental confusion

    • Medications such as opioids, iron supplements, antihistamines, antacids, and antidepressants

    • Habitual denial and ignoring the urge to defecate

• Fecal Impaction

  • Mass or collection of hardened feces in folds of rectum

  • Passage of liquid fecal seepage and no normal stool

  • Causes:

    • Poor defecation habits and constipation

    • Administration of medications such as anticholinergics and Antihistamines

    • Barium used in radiologic examinations of the upper and lower gi tracts, therefore; after these examinations, laxatives or enemas are usually given to ensure removal of the barium

  • Treatments:

    • Oil retention enema

    • Cleansing enema 2 – 4 hours later

    • Daily additional cleansing enemas, suppositories, or stool softeners

• Diarrhea

  • Passage of liquid feces and increased frequency of defecation

  • More than 3X/day with abdominal pain – increases bowel sounds

  • Diarrhea can cause serious fluid and electrolyte losses in body

  • Clostridium difficile

    • Produces mucoid and foul-smelling diarrhea

    • Clients include immunosuppressed, clients on chemotherapy, and those who have recently used antimicrobial agents, usually fluoroquinolones

    • Older adults have greatest risk due to underlying diseases and exposure in hospitals

    • Infection control

      • Hand hygiene, contact precautions, cleaning of surfaces with a bleach solution

      • Must wash with soap and water because alcohol-based hand gels are not effective against C. Diff – NO HAND SANITIZER

      • Wear gloves when coming into contact with soiled linens is needed to prevent the spread of the bacteria and spores that exist with C. Dif

  • Causes:

    • Psychological stress (anxiety)

    • Medications

      • Antibiotics

      • Iron

      • Cathartics

    • Allergy to food, fluid, drug

    • Intolerance of food or fluid

    • Diseases of the colon (e.g., malabsorption syndrome, Crohn’s disease)

  • Treatment:

    • Increase fluids (water) and electrolytes

    • Place on probiotics (yogurt, buttermilk)

    • Place on high soluble diet (white, bland, easy digest)

      • Ex: White bread (BRAT DIET)

• Steatorrhea

  • “Fatty Stool”

  • Caused from pancreatitis or is induced

• Bowel Incontinence or Fecal Incontinence

  • Loss of voluntary ability to control fecal and gaseous discharges

  • Bowel incontinence increases with age

  • Causes:

    • Impaired functioning of the anal sphincter or its nerve supply, such as in some neuromuscular diseases, spinal cord trauma, and tumors of the external anal sphincter muscle

  • Treatment:

    • Several surgical procedures to include

      • Repair of the sphincter and bowel diversion or colostomy

• Flatulence

  • Presence of excessive flatus in the intestines and leads to stretching and inflation of the intestines

  • AKA “gas,” may lead to gastric distention

  • Foods that cause gas – broccoli, spicy foods

• Assessment (pg. 1221)

  • Normal bowel patterns

  • Changes in bowel habits

  • History of elimination problems

  • Bowel elimination aids

    • Diet, exercise, medications, stress fluids

  • Focused physical assessment

  • Stool appearance

  • Diagnostic studies

  • Stool specimens in lab

• Interventions to Promote Regular Defecation

  • Privacy

  • Timing

    • When urge is recognized

  • Nutrition & Fluids

    • Constipation

      • Increase daily fluid intake and instruct client to drink hot liquids

      • Include fiber

    • Diarrhea

      • Encourage oral intake of fluids and bland food (BRAT diet)

      • Excessively hot or cold fluids should be avoided

    • Flatulence

      • Limit carbonated drinks

      • Straws or chewing gum

  • Exercise

    • Pelvic floor muscles

  • Positioning

    • SIT THEM UP

    • Bedpan

    • commode

• Managing Diarrhea (pg. 1261)

  • Drink at least 8 glasses of water per day to prevent dehydration

  • Consider drinking a few glasses of electrolyte replacement fluids a day

  • Eat foods with sodium and potassium. Most foods contain sodium. Potassium is found in meats and many vegetables and fruits, especially purple grape juice, tomatoes, potatoes, bananas, cooked peaches, and apricots

  • Increase foods containing soluble fiber, such as rice, oatmeal, and skinless fruits and potatoes

  • Avoid alcohol and beverages with caffeine, which aggravate the problem

  • Limit foods containing insoluble fiber, such as high-fiber whole-wheat and whole-grain breads and cereals, and raw fruits and vegetables

  • Limit fatty foods

  • Thoroughly clean and dry the perianal area after passing stool to prevent skin irritation and breakdown. Use soft toilet tissue to clean and dry the area. Apply a dimethicone-based cream or alcohol-free barrier film as needed

  • If possible discontinue medications that cause diarrhea

  • When diarrhea has stopped, reestablish normal bowel flora by eating fermented dairy products, such as yogurt or buttermilk

  • Seek a primary care provider consultation right away if weakness, dizziness, or loose stools persist more than 48 hours

• Teaching

  • Medications

    • Cathartics are drugs that induce defecation.

    • Laxative is mild comparison to a cathartic, soft or liquid stools with abdominal cramps.

    • Laxatives

    • Suppositories

      • Soften feces by releasing gases.

      • Best results when you give 30 minutes before normal defecation.

    • Antidiarrheal medications

      • Slow motility of the intestine or absorb excess in fluid

    • Anti-flatulence medications

      • Carminatives

  • Enemas

    • Prevent escape of feces during surgery.

    • Prepare intestine for certain tests such as x-ray or colonoscopy.

    • Remove feces instances of constipation or impaction

    • Cleansing Enema

      • Hypotonic (15-20 min)

        • Water moves out of color after it stimulates peristalsis

        • Causing water to move from the colon into interstitial space.

      • Hypertonic (5-10 min)

        • Draws fluid from interstitial space into the colon.

        • Small volume

      • Isotonic (15-20 min)

        • Considered the safest.

        • Normal saline

        • No fluid movement into or out of colon.

      • Hold 30 cm (12 in) above rectum

      • High cleansing enema hold 30 to 49 cm (12 to 18 in)

    • Retention Enema (1-3 hours)

      • Introduces oil into the rectum or medication into rectum.

      • Softens the feces and to lubricate the rectum.

    • Return-Flow Enema

      • Repeated 5 to 6 times

      • 100 to 200 mL of fluid into and out of rectum and sigmoid colon stimulates peristalsis.

      • Expel gas and abdominal distention

      • Allow flow back into container

      • Repeat several times, or until the distention is relieved.

    • Soapsuds Enema (10-15 min)

      • Irritates mucosa, distends colon

      • May damage mucosa

    • Oil Enema (mineral, olive, cottonseed) (1-3 hours)

      • Lubricated the feces and the colonic mucosa

      • Warm oil by running under warm water

      • Retain for 30 min.

• Administering Enemas (pg. 1227-1230)

  1. IWIPES

  2. Assist adult client to left lateral position (SIMS POSITION)

  3. Insert the enema tube – 3-4”

  4. Slowly administer the enema solution

     • **If you are using a plastic commercial container, roll it up as the fluid is instilled. This prevents subsequent suctioning of the solution.

  5. Encourage the client to retain the enema (as long as they can)

     • Ask the client to remain lying down & request that the client retain the solution for the appropriate amount of time (example: 5-10 mins for a cleansing enema or at least 30 mins for retention enema)

  6. Assist the client to defecate

     • Assist in sitting position (sitting facilitates the act of defecation)

  7. Document the type and volume, if appropriate, of enema given. Describe results

• Bowel Training Programs (pg.1269)

  • Indications: for clients who have chronic constipation, frequent impactions, or fecal incontinence

  • Phases:

    • Determine the client’s usual bowel habits and factors that help and hinder normal defecation

    • Design a plane with the client that includes the following:

      • Fluid intake of about 2,500 to 3,000 mL/day

      • Increase in fiber in the diet

      • Intake of hot drinks, especially just before the usual defecation time

      • Increase in exercise

• Colorectal Cancer Screening

  • Fecal Occult test annually beginning at age 50 OR

  • Stool DNA test at age of 50

  • Flexible Sigmoidoscopy every 5 years at age of 50 OR

  • Colonoscopy every 10 years at age of 50

  • Risk factors

    • Non-modifiable

      • Age, race, personal or family history, IBD

    • Modifiable

      • Cigarette smoking, poor diet, lack of physical activity, heavy consumption of alcohol

• What is the #1 cause of diarrhea? – C.Diff

• What is a guaiac test used for? – stool specimen that tests for blood in stool

• What is constipation and what causes it? Decreases frequency of defecation, hard dry stools – causes: dehydration, poor diet & opioids

Ch. 48 - Urinary Elimination

• Urination

  • Micturition, Voiding, Urinating

  • Adult bladder contains between 250 – 450 mL of urine

  • 1200-1500mL – normal range of output per day

  • 30-50mL – normal range per hour

• Factors Affecting Voiding

  • Developmental

    • Infants

    • Preschoolers

    • School-age Children

    • Older adults – size of kidneys decrease at age 50

  • Psychosocial

  • Fluid/Food Intake

  • Medications

    • Diuretics (ex: furosemide, chlorothizide) (caffine, alcohol, ADH)

    • Drug toxicity

    • NSAID/ASPRIN – nephrotoxicity

  • Muscle tone

    • Pelvic muscle tone contributes to the ability to store & empty urine

    • Deceases with age

  • Pathological conditions

    • Infections, kidney stones

  • Surgery & diagnostic procedures

    • Prostate

    • Caths for long period of time

    • BP meds

    • Spinal epidural

• Altered Urine Production (TABLE 48-3)

  • Polyuria

    • The production of abnormally large amounts of urine by the kidneys, often several liters more than the client’s usual daily output, usually more than 50mL an hour

    • Factors:

      • Ingestion of fluids containing caffeine or alcohol

      • Prescribed diuretic

      • Presence of thirst, dehydration and weight loss

      • History of kidney disease

  • Oliguria

    • Low urine output, usually less than 500 mL a day or 30 mL an hour for an adult

    • Factors:

      • Decrease in fluid intake

      • Signs of dehydration

      • Presence of hypotension, shock or heart failure

      • History of kidney disease

      • Signs of renal failure such as elevated blood urea nitrogen (BUN) and serum creatinine, edema, hypertension

  • Anuria

    • Lack of urine production

    • Factors:

      • Decrease in fluid intake

      • Signs of dehydration

      • Presence of hypotension, shock or heart failure

      • History of kidney disease

      • Signs of renal failure such as elevated blood urea nitrogen (BUN) and serum creatinine, edema, hypertension

• Altered Urinary Elimination

  • Urinary frequency – normal 4-6 times a day

    • Factors:

      • Pregnancy

      • Increase in fluid intake

      • UTI

  • Nocturia – urinate 2 or more times a night (elders/kids)

    • Factors:

      • Pregnancy

      • Increase in fluid intake

      • UTI

  • Urgency – sudden, strong desire to void

    • Factors:

      • Presence of phycological stress

      • UTI

  • Dysuria (associated with urinary hesitancy) – voiding is either painful or difficult

  • Enuresis – involuntary urination in children beyond the age when voluntary bladder control is normally acquired, usually 4-5 years of age

  • Urinary incontinence – involuntary leakage of urine or loss of bladder control (health symptom)

    • Factors: leakage when coughing, laughing, sneezing, retention, distended bladder on palpation and percussion (elders/pregnancy)

    • Transient (acute)

    • Established (chronic)

    • Psychosocial aspects, Urinary retention, Neurogenic bladder

• Assessing (See pg. 1220!)

  • Nursing history

  • Physical assessment and hydration status

  • Assessment of urine

  • Diagnostic tests and procedures

    • Urine specimens in lab

• Assessing Urine (See pg. 1221!)

  • Volume – 1200-1500ml/day

  • Color, clarity - straw

  • Odor

  • Sterility

  • pH: 4.5-8

  • Specific gravity: 1.005-1.030

    • Look at hydration status

    • Higher the concentration the higher the S. gravity number

  • Glucose

    • Negative is normal

  • Ketones

    • Negative is normal

  • Blood

    • Blood in urine is not normal

  • Measure residual urine

  • Diagnostic tests

    • Blood urea nitrogen (BUN): 10-20 (protein metabolism)

    • Creatinine clearance: 0.6-1.2 (muscle breakdown)

• Nursing Diagnoses

  • Impaired Urinary Elimination

  • Functional Urinary Incontinence (immobility)

  • Overflow Urinary Incontinence (bladder reaches full capacity)

  • Reflex Urinary Incontinence ( reaches a certain level and bladder spasm and you pee)

  • Stress Urinary Incontinence (pregnant women – cough, sneeze, laugh)

  • Urge Urinary Incontinence (gotta go, gotta go)

• Maintaining Normal Urinary Elimination

  • Respond to urge to void as soon as possible; avoid voluntary urinary retention

  • Empty bladder completely at each voiding

  • Emphasize the importance of drinking eight to ten 8-ounce glasses of water daily

  • Teach female clients about pelvic muscle exercises to strengthen perineal muscles

  • Inform the client about the relationship between tobacco use and bladder cancer and provide information about smoking cessation programs as indicated

  • Teach the client to promptly report any of the following to primary care provider; pain or burning on urination, changes in urine color or clarity, malodorous urine, or changes in voiding patterns (e.g., nocturia, frequency, dribbling)

• Prevention of UTI’s

  • Drink eight 8-ounce glasses of water per day to flush bacteria out of the urinary system

  • Practice frequent voiding (every 2 to 4 hours) to flush bacteria out of the urethra and prevent organisms from ascending into the bladder. Void immediately after intercourse

  • Avoid the use of harsh soaps, bubble bath, powder, or sprays in the perineal area. These substances can be irritating to the urethra and encourage inflammation and bacterial infection

  • Avoid tight-fitting pants or other clothing that created irritation to the urethra and prevents ventilation of the perineal area

  • Wear cotton rather than nylon underclothes. Accumulation of perineal moisture facilitates bacterial growth. Cotton enhances ventilation of the perineal area

  • Girls and women should always wipe the perineal area from front to back following urination or defecation in order to prevent introduction of GI bacteria into the urethra

  • If recurrent urinary infections are a problem, take showers rather than baths. Bacteria present in bath water can readily enter the urethra

  • Wiping front to back

• Managing Urinary Incontinence

  • Continence training

    • Bladder training (every 2 hours)

    • Habit training

    • Prompted voiding

  • Pelvic muscle exercises (Kegels)

  • Maintaining skin integrity

  • Use of external draining devices

  • Interventions to promote normal urinary elimination as discussed

  • Catheters

    • Cause of healthcare associated infection

    • Catherization (Pg. 1232-1233!)

    • Indications

      • Urinary retention

    • Types (Know why and when to use each one)

      • Indwelling or foley (anchors)

      • Straight (intermittent)

      • Suprapubic colostomy

    • Insertion

      • Males: 12 to 17.5 cm (6 to 7 in)

      • Females: 2.5 to 5 cm (1 to 2 in)

    • Complications

      • UTI’s

      • Trauma

• Applying an External Urinary Device (CONDOM CATH)

  1. IWIPES

  2. Position patient in supine or sitting position

  3. Apply gloves

  4. Inspect and clean penis

     • Clean the genital area and dry it thoroughly

  5. Apply and secure the condom

     • Roll the condom smoothly over the penis, leaving 2.5 cm (1 in) between the end of the penis and the rubber or plastic connecting tube

     • Some caths have an adhesive inside the proximal end that adheres to the skin of the base of the penis, if neither is present, use a strip of elastic take or Velcro around the base of the penis to cover the condom.

  6. Attach the urinary drainage system.

     • Make sure the tip of the penis is not touching the condom and that the condom is not twisted

  7. Teach about drainage system

  8. Inspect the penis 30 mins following the condom application and at least every 4 hour. Check urine flow. Document these findings.
     * Benefits: Decreased urinary tract infection risk
     * Downfalls: Difficult for longer term wear, do not stick well

• UAP’s can collect clean catches because they are not sterile techniques

  • Clean catch: Urine in Toilet, Urine in Cup (clean catch is mid-stream), Urine in Toilet

• Sterile Urine Specimen- inserting a straight or in and out catheter; or withdrawing a sample from an indwelling catheter. Do not take from collection bag b/c it may have been sitting in the bag for several hours. Do not disconnect the tube to obtain the specimen. Insert needless 20-30 ml syringe into the specimen port and aspirate. Transfer the specimen into a sterile specimen container. Be sure to unclamp tubing. Label at bedside.

• Clean catch- cleanse genitals before voiding and collect the sample mid-stream. This washes bacteria out and the mid-stream specimen will hopefully contain less microorganisms. Pour urine into a specimen container and label at bedside. Maintain sterility of container and lid.

  • Collect specimen after stream has begun (mid-stream)

• Freshly voided- collect the urine in usual manner as measuring I&O. Place into a specimen cup with client’s name, date, time. Transport to lab asap. Place in a specimen bag. Infants/small children- place a collection devise over genitals to collect the specimen.

• Place entire bag in a specimen container.

  • Potty hat, bed ban, urinal, commode.

  • When checking for residual- bladder scan or straight cath

• Nursing Care for Clients with Indwelling Catheters

  • Fluids

  • Dietary measures

  • Perineal care

  • Change catheter and tubing when necessary

  • Maintain sterile closed-drainage system

• Clean Intermittent Self-Catheterization

  • Performed by clients with neurogenic bladder dysfunction

  • Clean or medical aseptic technique

• How do we find out how much urine we have in our bladder? – bladder scanner

• If anyone is using a catheter what are they most at risk for? UTI

Ch. 47 – Nutrition

• Nutrition is the sum of all the interactions between an organism and the food it consumes. In other words, nutrition is what a person eats and how the body uses it. Nutrients are organic and inorganic substances found in foods that are required for body functioning.

• Special diets (page 1151)

  • NPO- nothing by mouth (Before patients are going in for surgery-Clear liquids 2hours prior to surgery)

  • Regular diet- House diet contains approx. 2000 daily calories.

  • Clear liquids- provides hydration and supplies some carbohydrates for energy needs. Water, tea, coffee, broth, clear juice (grape, apple, cranberry) popsicles, carbonated beverages, and gelatin. – (No RED, post-op patients, duration of 1-2 days)

  • Full liquids- Patients with GI disturbances. contains all clear liquids plus any food that are liquid at room temperature. Include soups, milk, milkshakes, puddings, custards, some hot cereals, juices, and yogurt. Difficult to obtain a balanced diet if needed for a longer period of time.

  • Mechanical soft (soft diet)- for clients with chewing difficulties (missing teeth, jaw problems, or extensive fatigue). Includes full liquids items plus soft vegetables and fruits, chopped, ground, or shredded meat; breads, eggs, and cheese.

  • Pureed (modification of soft diet)- blended diet. Any food item but altered by blending. (thinner consistency)

  • Thickened liquids- pudding, honey, nectar

    • *It takes less muscles to swallow thick liquid than thin liquid

  • Diet as tolerated- diet that works up the ladder, gradual increase in diet. (abdominal surgery patients.

  • Calorie restricted- for weight reduction (gastric bypass/weight loss)

  • Fat restricted- for clients with elevated cholesterol levels; may also be ordered for general weight loss

  • Hypoallergenic- patients that may have had allergic reactions to certain foods (ex milk)

  • Sodium restricted- for clients with HTN or fluid balance problems (diuretics, high BP, CHF- cardiac patient)

    • Foods sources for Na include milk, meat, baking soda, baking powder, spinach, carrots, beets

    • Foods with high sodium that need to be limited canned foods, processed foods, soy sauce

  • Dysphagia- soft diet, purred diet – difficulty swallowing due to a painfully inflamed throat or a stricture of the esophagus can prevent a person from obtaining adequate nourishment

  • Healthy heart- limit fat

  • Diabetes- limit carbs, sugars

  • Fluid restrictions- kidney failure

  • TPN: total parenteral nutrition:

    • Delivered venous catheter

    • Always risk for infection

    • Patient’s that are unable to maintain a normal nitrogen balance

    • Increase fluids, electrolyte, and glucose imbalance

    • *Dietitian determines the diet for the patients.

• Nursing Interventions to Promote Optimal Nutrition

  • Improving appetite (box 47-9; pg 1152)

    • Physical illness, unfamiliar or unpalatable food, environmental/psychological factors, physical discomfort or pain

    • Provide familiar food that the person likes

    • Select small portions so you do not discourage the client

    • Avoid unpleasant or uncomfortable treatments immediately before/after meals

    • Provide a clean environment

    • Encourage or provide oral hygiene before meal time

    • Reduce psychological stress

    • When providing the patient with a meal: use the clock system to describe location of food on the plate

  • Providing client meals (pg 1153)

    • Meal schedule

    • Routine is key

    • Find out what patient likes - Get to know list of food patient to make a diet plan for patient to get them to eat

    • Environment- make sure it’s a clean environment, room temperature is appropriate, make sure patient is positions upright and appropriate

    • Make sure patients drink water especially for elderly patients

    • Don’t encourage patients to drink while eating as it will fill stomach quicker

• Assisting Blind clients with meals

  • Identify placement of food as you would describe the time on a clock

  • **For a client with a visual impairment, identify the placement of the food as you would describe the time on a clock. Example: “The potatoes are at eight o’clock, the chicken at 12 o’clock, and the green beans at 4 o’clock.”

  • Make sure patient touches plate to become familiar with where plate and food is located

• Enteral Nutrition

  • Enteral- through the gastrointestinal system (NG tube, Peg, J tube)

    • Provided when unable to ingest foods or the upper GI tract is impaired & transport of food in interrupted

  • EN is provided through nasogastric and small-bore feeding tubes, G-tubes, or J-tube

  • NG tube (Nasogastric tube) – nostrils into stomach

  • G-tube (gast