Chapter 36 Gastrointestinal Intubation and Special Nutritional Modalities

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Chapter 36  Gastrointestinal Intubation and Special Nutritional Modalities

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. The nurse is preparing to place a nasogastric tube in one of her patients. What is the process for determining the length of a nasogastric tube to be placed in the stomach?
A) Place distal tip to nose, then ear tip and end of xiphoid process.
B) Instruct the patient to lie prone and measure tip of nose to umbilical area.

C) Insert the tube into nose until tube fills with secretions.
D) Obtain an order from the physician for the number of inches to insert the tube.

Ans: A
Chapter: 36
Client Needs: D-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Page and Header: 1023, Gastrointestinal Intubation

Feedback: Before inserting one of these tubes, the nurse determines the length that will be needed to reach the stomach or the small intestine. A mark is made on the tube to indicate the desired length. This length is traditionally determined by (1) measuring the distance from the tip of the nose to the earlobe and from the earlobe to the xiphoid process, and (2) adding 6 inches for

NG placement or 8 to 10 inches for intestinal placement, although studies do not necessarily confirm that this is a reliable technique. Options B, C, and D are not correct actions for the nurse to take when preparing to insert a nasogastric tube.

2. The patient is concerned about leakage of gastric contents out of the gastric sump tube the nurse has just inserted. What would the nurse do to prevent reflux gastric contents from coming through the blue vent of a gastric sump tube?
A) Prime the tubing with 20 mL of normal saline.

B) Keep the vent lumen above the patient’s waist. C) Maintain the patient in a high Fowler’s position. D) Have the patient pin the tube to the thigh.

Ans: B
Chapter: 36
Client Needs: D-3
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Page and Header: 1022, Gastrointestinal Intubation

Feedback: The blue vent lumen should be kept above the patient’s waist to prevent reflux of gastric contents through it; otherwise it acts as a siphon. A one-way anti-reflux valve seated in the blue pigtail can prevent the reflux of gastric contents out the vent lumen. To prevent reflux you do not prime the tubing, maintain the patient in a high Fowler’s position, or have the patient pin the tube to the thigh.

3. Your patient is on tube feedings and is experiencing diarrhea. You suspect the patient is experiencing dumping syndrome. How might the nurse help to alleviate this problem? A) Stop the tube feed.
B) Increase the hourly feed rate.

C) Dilute the feeding solution. D) Administer an antidiarrheal.

Ans: C
Chapter: 36
Client Needs: D-3
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process

Objective: 5
Page and Header: 1031, Gastrointestinal Intubation

Feedback: Dumping syndrome can generally be alleviated by starting with a dilute solution and then increasing the concentration of the solution over several days. You do not stop the tube feeding or increase the hourly feed rate. Administering an antidiarrheal will not stop dumping symdrome.

4. The nurse is admitting a patient to the unit after having a gastrostomy. What is a potential postoperative complication of a gastrostomy?
A) Premature removal of the tube
B) Dehydration

C) Diarrhea
D) Decrease in sodium

Ans: A
Chapter: 36
Client Needs: D-3
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Page and Header: 1032, Gastrostomy and Jejunostomy

Feedback: A postoperative complication of a gastrostomy is GI bleeding. Other complications include wound infection and premature removal of the tube. Dehydration, diarrhea, and decrease in sodium levels are not typical complications.

5. The nursing instructor is talking about caring for patients with feeding tubes and endotracheal tubes (ET). The instructor tells the students that before each tube feeding, the nurse should check for tube placement in the stomach as well as residual volume. What is the purpose of the nurse’s actions?
A) Prevent gastric ulcers
B) Prevent aspiration
C) Prevent abdominal distention
D) Prevent diarrhea

Ans: B
Chapter: 36 Client Needs: D-3

Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 3

Page and Header: 1029, Gastrointestinal Intubation

Feedback: Protecting the client from aspirating is essential because aspiration can cause pneumonia, a potentially life-threatening disorder. Gastric ulcers aren’t a common complication of tube feeding in clients with ET or tracheostomy tubes. Abdominal distention and diarrhea can both be associated with tube feeding, but neither is immediately life-threatening.

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