Gastrointestinal System Disorders Q 126 - Gyan Darpan : Learning Portal
Get GK Updates on WhatsApp

Post Top Ad

Thursday, 14 April 2022

Gastrointestinal System Disorders Q 126

An intubated patient is receiving continuous enteral feedings through a Salem pump tube at a rate of 60ml/hr. Gastric residuals have been 30-40ml when monitored Q4H. You check the gastric residual and aspirate 220ml. What is your first response to this finding?
    A. Notify the doctor immediately.
    B. Stop the feeding, and clamp the NG tube.
    C. Discard the 220ml and clamp the NG tube.
    D. Give a prescribed GI stimulant such as metoclopramide (Reglan).

Correct Answer: B. Stop the feeding, and clamp the NG tube.

A gastric residual greater than 2 hours worth of feeding or 100-150ml is considered too high. The feeding should be stopped; the NG tube clamped, and then allowed time for the stomach to empty before additional feeding is added. Gastric residual volume is the amount of liquid drained from a stomach following administration of enteral feed; this liquid consists mainly of infused nutritional formula or water, and secreted GI juice. Gastric residual volume is measured either by aspiration using a syringe, or by gravity drainage to a reservoir.

Option A: It is unnecessary to notify the physician immediately. Monitoring GRV involves obtaining frequent GRV measurements and employing appropriate interventions in patients with large GRVs. Gastric residual volume monitoring (monitoring of residual volume of the enteral nutrients including digestive juices) is an essential component of EN patient care and aids in preventing complications due to EN.
Option C: Administering additional enteral nutrients in patients with increased GRVs may cause aspiration and an increase in intra?abdominal pressure, which increases the risk of respiratory and circulatory failure, and intestinal necrosis. For this reason, it is particularly important to monitor GRV in the early stages of administration of enteral nutrition, especially in critically ill patients.
Option D: Frequency of GRV measurement (e.g. every six hours) and the intervention strategy for large GRVs (e.g. if GRV is above 500 mL, hold feeding for two hours and re?check GRV) is usually decided as per institution?specific protocols and needs of the inpatient population.

No comments:

Post a Comment

Post Top Ad