What is the proper technique with gravity tube feeding?
Hang the feeding bag 1 foot higher than the tube’s insertion point into the client.
Administer the next feeding only if there is less than 25 mL of residual volume from the previous feeding.
Place client in the left lateral position.
Administer feeding directly from the refrigerator.
The Correct Answer is A
Gravity tube feeding relies on hydrostatic pressure to deliver formula from a bag through the feeding tube. Safe technique includes correct bag height to regulate flow, positioning the patient to reduce aspiration risk, checking residuals per policy, and warming formula to room temperature for tolerance.
Rationale for correct answer:
1. Hang the feeding bag 1 foot higher than the tube’s insertion point into the client: This provides adequate hydrostatic pressure for a controlled gravity flow while reducing need for excessive bolus pressure. Always regulate flow with the roller clamp and monitor the patient.
Rationale for incorrect answers:
2. Administer the next feeding only if there is less than 25 mL of residual volume from the previous feeding: A 25 mL cutoff is unrealistically low. Traditional thresholds for holding feedings have been much higher.
3. Place client in the left lateral position: The safest position for enteral feeding to reduce aspiration is upright (high-Fowler’s) or at least a 30°-45° elevated head of bed.
4. Administer feeding directly from the refrigerator: Cold formula can cause cramping and poor tolerance; feeding solutions should be warmed to room temperature before administration.
Take home points
- Position the patient upright (head of bed 30°- 45°) during and for at least 30 - 60 minutes after gravity tube feeding to lower aspiration risk.
- Use the roller clamp to control the gravity flow; always follow facility policy for residual-volume checks and feeding procedures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Patients with dysphagia are at high risk for aspiration. When a patient being fed suddenly chokes, the immediate priority is to stop the offending activity so nothing more enters the airway and you can assess and manage the airway.
Rationale for correct answer:
4. Stop feeding her: Stopping the feeding immediately prevents additional material entering the airway and allows you to quickly assess the patient, call for help if needed, and institute airway-clearance measures.
Rationale for incorrect answers:
1. Suction her mouth and throat: May be needed if secretions or visible food are present and the patient cannot clear them, but suctioning is secondary to first stopping the feed and assessing the airway/level of obstruction.
2. Turn her on her side: Turning to the side helps drain secretions and reduces risk of aspiration into the lungs (useful after stopping the feed), but it is not the first immediate action.
3. Put on oxygen at 2 L nasal cannula: Oxygen can help if the patient becomes hypoxic, but oxygen does not remove an obstruction. Do not delay airway clearance to apply oxygen.
Take home points:
- Immediately stop the feed at the first sign of choking.
- Then assess airway, breathing, and level of consciousness and act (encourage cough, Heimlich, suction, or CPR) according to the patient’s response.
Correct Answer is A
Explanation
Chronic alcohol use profoundly affects nutrition. Alcohol interferes with absorption, storage, and metabolism of essential vitamins and minerals, particularly the B vitamins. Nurses caring for clients with alcohol dependence must anticipate and manage nutritional deficiencies to prevent complications such as anemia, neuropathy, or Wernicke-Korsakoff syndrome.
Rationale for correct answer:
1. Vitamin B malnutrition: Alcohol interferes with absorption and metabolism of B vitamins (especially thiamine, folate, and B12), leading to neurological and hematological problems.
Rationale for incorrect answers:
2. Obesity: Although alcohol is calorie-dense, most chronic alcoholics tend to suffer from malnutrition rather than obesity.
3. Dehydration: Alcohol has a diuretic effect, but the key nutritional issue is vitamin deficiency, not fluid imbalance.
4. Vitamin C deficiency: Less commonly associated with alcoholism compared to Vitamin B deficiencies.
Take home points:
- Alcoholism is strongly associated with Vitamin B deficiencies, particularly thiamine.
- Thiamine supplementation is essential to prevent complications such as Wernicke’s encephalopathy.
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