Patients with Tubes

Your patient has a PEG tube and you are about to administer a feeding. While checking residual you obtain 95 ml of stomach contents. What would be your next nursing intervention?

• • Hold the feeding and immediately notify the MD of the assessed amount of residual

• • Administered the scheduled feeding

• • Wait 30 minutes and reassess residual

• • Skip this scheduled feeding and administer the next feeding due in 6 hour

Which patient would benefit from a Nasogastric Tube?

• • A stroke victim who failed their swallow evaulation

• • A patient with Congestive Heart Failure

• • A patient who had a left leg amputation

• • A patient with a Platelet count of 50

Your patient has a PEG tube and you are about to administer a tube feeding using the feeding pump. You note that the last feeding tube hanging on the pole is labeled Aug 16 and today's date is Aug 18. Which nursing action is correct.

• • Immediately discard the tubing and open a new package of tubing before proceeding with the feeding

• • Continue to administer the feeding because the tubing is good for 4 days

• • Change the adapter cap at the end of the tubing

• • Notify the MD for further orders

You are receiving report from a nurse at another hospital who will be transferring a patient to your ICU. The patient has a Sengstaken-Blackmore Tube. Which of the following statement is incorrect about this tubing?

• • It is a four-lumen gastric tube

• • It is used in patient's with esophageal varices

• • A NG tube is inserted in the opposite nare to collect secretions

• • Scissors are kept at the beside at all times with this tubing type

You are caring for a patient with a nephrostomy tube. What nursing intervention would you include in your plan of care?

• • Maintain patency of the tube

• • Irrigate as prescribed by the MD using sterile water

• • Clamp the tube every 6 hours for 1 hour intervals

• • Keep tube in a vertical position at all times

Your patient has an endotracheal tube. You are assessing placement by listening to the lung sounds and you notice that the breath sounds and chest wall movement are absent on the left side? What is usually the cause of this?

• • The tube is not above the carina and must be re-inserted

• • The incorrect size tubing was used

• • A pneumothorax may be developing and a STAT chest x-ray should be ordered

• • The tube may be displaced in the right main stem bronchus

You patient is ordered a chest x-ray to confirm endotracheal tube placement. The tube should be how many cm above the carina?

• • 0.5-1.5 cm

• • 1-2 cm

• • 1-4 cm

• • 2-3 cm

You are assessing your patient with an endotracheal tube and note that the patient is able to make verbal sounds. What is the most likely cause?

• • There is an occlusion.

• • There is a leak.

• • The tube is displaced.

• • None of the above. This is normal.

A patient with a tracheostomy needs to be suctioned. What would you do first before suctioning the patient?

• • Disconnect pulse oximetry

• • Assist the patient into Sim's position

• • Hyperoxygenate the patient before suctioning

• • Have the patient bear down

Your patient has a chest tube. Your assessing the water seal chamber and you note that the water moves up as the patient inhales and then moves down when the patient exhales. What may be causing this to happen?

• • This is normal and expected.

• • The chest tube has a leak.

• • The left chest tube is occluded.

• • The water seal suction should be increased 2-5 mmHG.