Enteric Tubes

Card Set Information

Enteric Tubes
2013-10-02 23:11:28
enteric tubes vet vettech medicine

Enteral Tubes
Show Answers:

  1. What type of tube would be used to lavage a patient's stomach?
    Orogastric tube
  2. What are some reasons as to why we would perform gastric intubation
    emptying or lavage of the stomach, short term nutrient admin or admin of gastric soln (Barium)
  3. What does it mean to lavage?
    To admin fluid and siphon fluid back; so the substance will linger then leave the body with stomach contents
  4. Define gavage.
    Feeding through the use of a tube. Admin only- not siphoning contents back, admin food but not force feeding.
  5. Define enteral.
    With or by way of intestine.
  6. Where does enteral feeding deliver nutrients to?
    Directly to the stomach, duodenum, or jejunum
  7. Define orogastric.
    via the oral cavity. mouth to stomach.
  8. What is the best feeding route with a tube if there are no contraindications?
    Gastric tube
  9. What is the trade name of Activated Charcoal?
  10. What is activated charcoal used for?
    Absorbing ingested toxins.
  11. How do you measure for a gastric tube?
    measure from tip of nose to 13th rib.
  12. what is the reason for measuring the gastric tube?
    to make sure you're actually within the lumen of the stomach
  13. What can happen if a gastric tube is inserted too far into the stomach?
    Perforation of stomach. Tube can hit stomach wall and twist around and come back up esophagus
  14. Is sedation needed for orogastric tubes? Explain.
    Dogs- no- if patient does well and only to relieve gas or admin barium. if patient needs food or toxins removed then sedation needed

    cats- sedation always needed.
  15. Why do we not want to perform gastric lavage on awake patients?
    they can aspirate the fluid being lavaged and could cause aspiration pneumonia.
  16. What is the purpose of endotracheal intubation?
    Provide an airway for admin of O2 and anesthetics; to prevent aspiration of fluids.
  17. Where are you normally able to palpate the tube during gastric intubation?
    Cervical region, dorsal to the trachea.
  18. How can you check to see if gastric tubes are correctly placed into the stomach?
    Inject 5-10 mls of air into tube and ascult cranial abd. if gurgling sounds present, tube is in GI tract. Can inject 5 mls of saline into tube and if patient coughs tube incorrectly placed. Also can radiograph.
  19. How many times should gastric lavage be repeated before removing tube?
    8-10 times
  20. what must you do to the gastric tube before removing the tube and why?
    double kink the tube to avoid spilling from tube into trachea, helps avoid aspiration
  21. During recovery from anesthesia after gastric lavage, what is the main thing we need to monitor for?
    V+, can lead to more aspiration
  22. What is an OGT?
    orogastric tube
  23. What is an NG?
    Nasogastric tube
  24. What is an NE?
    Nasoesophageal tube
  25. What are some indications for the use of NE/NG tubes?
    Feedings- liquid diets only!
  26. How long are NE/NG tubes kept in place?
    normally less than 5d, used for short term feeding only.
  27. Contraindications for NE/NG tubes?
    V+ or no gag reflex.
  28. Where do you measure for the NG tube and why?
    Tip of nose to 13th rib- ensure you are within the lumen of the stomach
  29. Where do you measure for NE tubes and why?
    Tip of nose to 8th/9th rib- ensure you're in distal esophagus
  30. What type of sedation is normally needed for NE/NG tube placement?
    normally none
  31. What are pharyngostomy tubes usually indicated for?
    Anorexic patients and those with facial trauma.
  32. What are some contraindications for pharyngostomy tubes?
    non-fx GI tract
  33. Where does the pharyngostomy tube enter the esophagus?
    through small incision on the right side of the neck behind the mandible to the distal esophagus
  34. Where do you measure for pharyngostomy tubes?
    from the angle of the mandible to the distal esophagus
  35. What type of suture pattern is used to hold most tubes in place?
    Chinese finger trap
  36. When tube feeding, what is an indication of over feeding?
    V+-sign of over extending the stomach
  37. Which tube is better tolerated by the patient, pharyngostomy or esophagostomy tube?
    Esophagostomy because less laryngeal irritation/obstruction; less likely to dislodge and less likely to induce emesis.
  38. What is a contraindication of esophagostomy tube?
    non-fx GI tract
  39. Where would you measure for an esophagostomy tube?
    mid-cervical esophagus to 7th rib
  40. What does the PEG in PEG tube stand for?
    Percutaneous Endoscopic Gastrotomy
  41. Where does a PEG tube sit within the patient's abdomen?
    The stomach.
  42. After placement of a PEG tube, when can you begin to use it, and why?
    Wait 72 hrs before, seal needs to form.
  43. What are major concerns with the use of PEG tubes? DPHSDU
    Dehiscence, Poor healing, sepsis, decubital ulcers
  44. Are patients with PEG tubes more susceptible to these complications? Why or why not?
    Yes, 3x's more susceptible due to the under-nourishment of the patient.
  45. What is a gastroduodenostomy tube?
    A feeding tube that bypasses the stomach and sits in the duodenum
  46. In what situations would a gastroduodenostomy tube be preferred?
    Stomach cancer, malfunctioninh pyloric valve, gastric blockage, peptic ulcers
  47. What are some complications of a gastroduodenumostomy tube?
    wound dehiscence, poor healing, sepsis, ulcers, peritonitis
  48. Jejunostomy tubes are AKA what?
  49. Where does the j-tube sit in the abdomen?
  50. What are some complications of a J-tube?
    wound dehiscence, poor healing, sepsis, ulcers, pertonitis
  51. Advantages of J-tube?
    Can achieve caloric intake; eliminates risk of aspiration
  52. What are some disadvantages of J-tubes?
    Water transfer to gut lumen, resulting in cramping and D+
  53. What are some indications for any feeding tube placement?
    Anorexia, facial/mandibular/maxillary trauma, added nutrional support, admin of meds, evacuation of gastric contents
  54. When do you flush a feeding tube?
    Before and after a feeding
  55. What do you normally flush a tube with prior to feeding?
    Water or sterile saline depending on type of tube.
  56. What type of feeding tubes are meant for short term use only?
    NE/NG tubes
  57. Which types are tubes can be used for long-term use?
    Esophagustomy tubes, gastroduodenostomy tubes, PEG tubes
  58. What tubes are patients more susceptible to have complications with due to lack of nutrition?
    PEG tubes, Gastroduodenostomy tubes
  59. Why is it important to have proper inflation of the cuff of an endotracheal tube?
    Helps control anesthetic depth, avoids aspiration of gastric contents when v+ from lavage, prevention of hypoxia
  60. After measuring for the placement of an NE/NG tube, what is the next most important step?
    Instill a topical/local anesthetic into nostrils
  61. Why are pharyngostomy tubes not frequently used in dogs and cats?
    Can cause pharyngeal edema, there is a high risk of aspiration and the patients experience more gagging and a higher rate of dislodgement with this type of tube
  62. What is the purpose of flushing a tube before and after feeding?
    Before- to ensure patency and proper placement

    After- to help prevent occlusion
  63. What tyoe of healing is used after a PEG tube is removed?
    Second Intention
  64. If you only have an option between giving a patient parenteral nutrition and enteral nutrition, which would you choose and why?
    Enteral, if the gut works use it. Best route of nutritional support asnd encourages the movement and normal fx of the gut.
  65. What is a pharyngostomy?
    creation of an artificial opening into the pharynx
  66. what is a gastrostomy?
    creation of an opening in the stomach
  67. What is an esophagostomy?
    Creation of an artificial opening within the esophagus
  68. What is insufflate?
    Introduction of gas into a body cavity
  69. What is a jejunostomy?
    Creation of an opening between the jejunum and surface of the abdominal wall
  70. What tube is it a standard practice to use a mouth gag for?
    Orogastric tube
  71. Which tube is more permanent method of nutritional support?
    PEG tubes
  72. What is a gastrolavage?
    The force feeding or irrigation of the stomach through a tube that was surgically placed in the stomach
  73. What is used to hold and secure an enteral tube to the animal's side?
    Pet Net
  74. Which tube requires a CRI to deliever liquid or special diet?
  75. What tubes do not generally not need anesthesia?
    NE/NG and orogastric tubes
  76. Where can an NE/NG tube be sutured into place?
    Nostril (inside nare), bridge of nose, forehead