When irrigating a percutaneous endoscopic gastrostomy (PEG) tube with an intermittent bolus feeding which of the following steps should be taken?

Remove the PEG tube from the stoma and clean it with soap and water.

Administer the bolus feeding through the PEG tube without flushing it first.

Use a syringe to flush the tube with 30 m of water before and after the bolus feeding

Skip the flushing step of the PEG tube is already patent

Answer and Explanation

The Correct Answer is C

A. Remove the PEG tube from the stoma and clean it with soap and water: The PEG tube is a surgically placed device and should never be removed by the nurse unless ordered or in an emergency (e.g., dislodgement).

B. Administer the bolus feeding through the PEG tube without flushing it first: Flushing before and after prevents clogging and ensures tube patency.

C. Use a syringe to flush the tube with 30 mL of water before and after the bolus feeding: This is the standard protocol to maintain tube patency and prevent clogging.

D. Skip the flushing step if the PEG tube is already patent: Even if the tube appears patent, flushing before and after feeds is still necessary to prevent build-up and blockage.

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Correct Answer is ["B","C","E","F"]

Explanation

Mucous membranes pink, skin warm and dry: These are normal findings and do not require follow-up.

Coughing and clearing throat when eating: This suggests possible aspiration, especially concerning in post-stroke clients.

Voice hoarse after swallowing: A hoarse voice post-swallow is a red flag for aspiration risk and should be evaluated promptly.

Temperature 38 °C (100.4°F): This is a low-grade fever and not immediately concerning without other symptoms.

Bilateral breath sounds with wheezing heard in upper lobes: New-onset wheezing indicates possible airway inflammation, aspiration pneumonia, or respiratory distress.

Oxygen saturation 88% on room air: An O₂ saturation below 90% indicates hypoxemia, requiring immediate attention and supplemental oxygen.

A. "The end of the stoma will be painful after this procedure B. "You should expect your stoma to be a purple color." C. "You will have sold stool pass through your stoma." D. "You will have a stoma placed in your right lower abdomen."

Correct Answer is D

Explanation

A. "The end of the stoma will be painful after this procedure": The stoma has no nerve endings, so it should not be painful.

B. "You should expect your stoma to be a purple color.": A healthy stoma is pink to red; purple or dark color suggests poor perfusion and requires immediate attention.

C. "You will have solid stool pass through your stoma.": An ileostomy produces liquid to semi-liquid stool, as the large intestine (which absorbs water) is bypassed.

D. "You will have a stoma placed in your right lower abdomen.": An ileostomy is usually created from the ileum and placed in the right lower quadrant.

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When irrigating a percutaneous endoscopic gastrostomy (PEG) tube with an intermittent bolus feeding which of the following steps should be taken?

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["B","C","E","F"]

Explanation

A nurse is assisting with teaching a client who is preoperative for an ileostomy. Which of the following statements should the nurse include?

Correct Answer is D

Explanation

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