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2 CE Test Hours

Early Percutaneous Endoscopic Gastrostomy Tube Dislodgment

Contrada, Emily

AJN The American Journal of Nursing: June 2015 - Volume 115 - Issue 6 - p 32,46
doi: 10.1097/01.NAJ.0000466318.31261.04
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GENERAL PURPOSE:

To provide information about gastrostomy techniques, complications, preventive strategies, and tube management, using an illustrative case study.

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LEARNING OBJECTIVES:

After reading this article and taking this test, you will be able to

  • recognize appropriate gastrostomy techniques and tube management strategies.
  • identify interventions for tube dislodgment and other complications.
  1. Enteral nutrition delivers nutrients to either the stomach or the
    1. colon.
    2. bloodstream.
    3. small intestine.
  2. The procedure for inserting a percutaneous endoscopic gastrostomy (PEG) tube typically takes
    1. 15 to 20 minutes.
    2. 30 to 45 minutes.
    3. 60 to 90 minutes.
  3. Percutaneous insertion involves passing a fiberoptic gastroscope through the
    1. rectum.
    2. oropharynx.
    3. abdominal wall.
  4. During the procedure, insufflation shifts the position of which of the following structures away from the intended fistula tract?
    1. spleen
    2. stomach
    3. pancreas
  5. The external bolster that secures the tube is also called a
    1. cap.
    2. buffer.
    3. bumper.
  6. Although the tract begins to mature 1 to 2 weeks after the procedure, complete maturation can take
    1. 3 to 4 weeks.
    2. 4 to 6 weeks.
    3. 6 to 8 weeks.
  7. In which method is the internal bolster usually a balloon rather than a solid structure?
    1. pull
    2. introducer
    3. percutaneous radiologic gastrostomy
  8. In which method is the anterior gastric wall anchored to the abdominal wall before tube insertion by placing T-fasteners around the tube insertion site?
    1. pull
    2. push
    3. percutaneous radiologic gastrostomy
  9. Insertion of a PEG tube carries immediate intraoperative risks, including which of the following?
    1. aspiration
    2. peritonitis
    3. sepsis
  10. Later complications of PEG tube insertion include
    1. hepatic injury.
    2. pneumoperitoneum.
    3. necrotizing fasciitis.
  11. Which complication of PEG tube insertion has been shown to have the greatest impact on morbidity and mortality?
    1. aspiration of enteral formula into the pulmonary system
    2. inadvertent tube dislodgment before mature tract formation
    3. infection of the gastrointestinal system during the procedure
  12. Of the following measures, which should nurses use to keep patients at high risk for tube removal from dislodging the tube?
    1. abdominal binders
    2. vest restraints
    3. sedation
  13. For the first 10 days after tube placement, the recommendation is to clean the site daily with
    1. sterile water.
    2. soap and water.
    3. saline and sterile gauze.
  14. To prevent tube adherence to the tract, nurses should perform which action daily?
    1. Pull the tube outward and rotate it.
    2. Push the tube forward and rotate it.
    3. Rotate it without any pulling or pushing.
  15. Which of the following complications should nurses suspect when a patient with a PEG tube develops pain during feeding and there is resistance to flow related to peritubal leakage?
    1. peritonitis
    2. aspiration
    3. tube migration
  16. Which of the following complications should nurses suspect when a patient with a PEG tube develops abdominal pain or tenderness, fever, and leukocytosis?
    1. peritonitis
    2. aspiration
    3. tube migration
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