Indicators of Tubesite During Feedings

~ Exam ~

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As a result of completing this educational program the learner will be able to:

  1. Describe the efficacy of external tube length measurement in determining if a feeding tube has remained in the correct position during continuous tube feedings.
  2. Describe the efficacy of using aspirate appearance in determining if a feeding tube has remained in the correct position during continuous tube feedings.
  3. Describe the efficacy of aspirate volume measurements in determining if a feeding tube has remained in the correct position during continuous tube feedings.
1. Assume a feeding tube has been placed in the stomach and continuous feedings have been started. Which of the following assessments likely indicates that the tube has remained in the correct position?
  a. The mark placed on the exit site of the feeding tube has moved outward by 6 cm.
  b. No aspirate can be obtained with a 60 ml syringe.
  c. The pH of aspirate from the feeding tube is 4.
  d. The appearance of aspirate from the feeding tube is that of unchanged formula.

2. Assume a feeding tube has been placed in the small bowel and continuous feedings have been started. Which of the following assessments likely indicates that the tube has not remained in the correct position?
  a. The mark placed on the exit site of the feeding tube at the time of initial placement has not changed.
  b. No aspirate can be obtained with a 60 ml syringe.
  c. The pH of aspirate from the feeding tube is 7
  d. The appearance of aspirate from the feeding tube is that of curdled formula.
3. Assume that an aspirate from a feeding tube has the appearance of dark golden yellow tinged formula. Which feeding tube site is most probable?
  a. Esophagus
  b. Stomach
  c. Small Bowel
  d. Bronchus

4. The easiest site from which to withdraw fluid from a feeding tube via syringe during continuous feedings is the:
  a. Esophagus
  b. Stomach
  c. Duodenum
  d. Jejunum

5. Although no change has been observed in the external tubing length, which of the following could account for positive indicators of displacement of a small bowel tube into the stomach?
  a. Higher than normal gastric pH
  b. Reflux of bile into the stomach
  c. Coiling of the tube in the stomach
  d. Tugging at the tube by a confused patient

6. The most reliable method to determine tube placement is:
  a. Measuring the pH of aspirates
  b. Observing for changes in appearance of aspirates
  c. Obtaining a radiograph
  d. Observing for changes in aspirate volume

7. Which of the following situations is least likely to predispose a patient to aspirate formula during continuous feedings?
  a. Ports of tube situated in the esophagus
  b. Ports of tube situated at the gastroesophageal junction
  c. Ports of tube situated in an atonic stomach
  d. Ports of tube situated in the duodenum

8. Which of the following factors is as reliable during feedings as when feedings are not in progress?
  a. pH of aspirate from the feeding tube
  b. Appearance of aspirate from the feeding tube
  c. Consistency of aspirate from the feeding tube
  d. Length of tubing extending from the exit site

9. Serial measurement of residual volume from small bowel tubes is advocated by some authors to monitor for:
  a. Poor gastric motility
  b. Tube displacement into the stomach
  c. Disrupted formula flow
  d. Migration of tube into the distal small bowel

10. Limitations of the study include:
  a. Small sample size
  b. Inconsistent availability of radiographs
  c. Use of pH paper rather than pH meters
  d. Data collection by a single individual