NCSBN guidelines for Professional Boundaries in Nursing - ANS-Maintain professional
boundaries & strengthen therapeutic nurse-patient relationship.
ANA Code of Ethics Provisions 6 - ANS-The nurse, through individual & collective effort,
establishes, maintains and improves the ethical environment of the work settings & conditions of
employment that are conducive to safe, quality healthcare.
ANA code of ethics Provisions 8 - ANS-The nurse collaborates with other health professionals
and the public to protect human rights, promote health diplomacy & reduce health disparities.
NG tube used for suction - ANS-Levin tube- single lumen with holes near tip; salem sump
preferred for stomach decompression. Double lumen- one for removal of gastric contents and
other air vent "pigtail"
nasogastric tube - ANS-go straight into the stomach
nasointestinal tube - ANS-smaller bore, more flexible, preferred if getting tube feeding for a
week or more
How to check placement of feeding tube before starting feedings - ANS-Elevate the HOB - 90
degrees if not contraindicated
X-ray confirmation is required prior to administration of feeding
Check for placement
Check for gastric residual volume (GRV)
Assess for gagging, coughing, or choking
, Know how to check placement of a nasogastric tube - ANS-Initial x-ray verification,
re-verify before giving meds/food;
re-verify every 4-6 hours;
color of aspirate & check pH and auscultation (inject air embolus and listen to hear whoosh and
see if it's in the stomach) should be less than or equal to 5
ph of gastric - ANS-color: dark green, cloudy, dingy yellow and clear, dark brown
ph: < 5.0
ph of intestinal - ANS-color: clear, clear and dingy yellow, clear brown
ph: >6.0
ph of pulmonary - ANS-color: cloudy yellow
ph: > 6.0
How to check residual and know what to do with aspirant - ANS-Assess residual (tolerance of
feedings) by performing syringe aspiration (q4-6 hr; see if pt is tolerating it); usually stop
feedings if gastric residual is more than 500 mL or 250 mL when 2 measurements are taken 1
hour apart.
Difference in how to insert a NG tube for suction vs NG/NI tube for feedings - ANS-
How to give feedings and medications through feeding tube - ANS-- Continual: use enteral
pump
- Intermittent: bolus feeding, syringe & drip in by gravity
- Admin. all food at room temp and auscultate for bowl sounds, position pt in high fowler's or
Trendelenburg, verify placement and check residual
difference between a straight and indwelling catheter - ANS-Indwelling catheter: remains in the
bladder after urination
Straight catheter: removed from the bladder after urination (one time use)
When should enteral feedings be held? - ANS-
How to care for a gastronomy or jejunostomy tube - ANS-- Exit site may have dressing or be
open, assess site for excoriation, drainage, signs of infection or bleeding (q 4-6 hrs), cleanse
around site with warm water and mimld soap, place dressing if indicated; document
appearance, drainage & app. of dressing
Risk factors for nutritional problems - ANS-- Clear or full liquid diets for more than 3 days without
nutrient supplementation
- IV feeding for NPO- for more than 3 days without nutrient supplementation
- Low intakes of prescribed diet or tube feedings
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