The registered nurse observes a graduate nurse who is inserting a small-bore nasojejunal feeding tube. Which action by the graduate nurse requires intervention by the registered nurse?

Question

The registered nurse observes a graduate nurse who is inserting a small-bore nasojejunal feeding tube.  Which action by the graduate nurse requires intervention by the registered nurse?

Quizplus · Accepted Answer

11ecbb05_cb84_a0bd_b433_df5247d9c1de_MD0009_00 Small-bore nasoenteric (eg, nasoduodenal, nasojejunal) tubes are often placed using a stylet (guide wire), a metal wire running through the tube that facilitates advancement through the gastrointestinal tract. Once the tube is inserted, the nurse should obtain an x-ray to verify that the tube terminates in the intestine as prescribed, not in the airway or stomach. After placement verification, the nurse should remove the stylet to allow tube feeding (Option C). To avoid perforating the gut, the nurse should never reinsert the stylet when a feeding tube is in place. If the tube is not properly positioned and the stylet has been removed, the nurse must remove the tube and start over. (Options A and D) The client should sip water during insertion to close the airway and open the esophagus. With each swallow the nurse should advance the tube a little. The nurse should stop advancing when the client is inhaling or coughing to avoid inserting the tube into the airway and then continue advancing when the client is able to swallow again. (Option B) Marking the exit point from the naris on the tube allows visualization of changes in external tube length that may indicate tube dislodgement. Educational objective: After placing a new, small-bore nasoenteric (eg, nasoduodenal, nasojejunal) feeding tube, the nurse should obtain an x-ray to verify tube placement and should leave the stylet (guide wire) in place until tube placement is verified. The nurse should never reinsert a stylet into a nasoenteric tube.

The Registered Nurse Observes a Graduate Nurse Who Is Inserting