Before starting tube feeding, the nurse reviews this radiograph. Click the enteral tube tip showing placement in the right bronchus.
Hot Spot
Choose your responses, then check the answer.
Explanation
The enteral tube follows the tracheobronchial tree and terminates in the right bronchus instead of passing below the diaphragm into the stomach. Feeding must not begin.
Quick answer The enteral tube follows the tracheobronchial tree and terminates in the right bronchus instead of passing below the diaphragm into the stomach. Feeding must not begin.
Why this is correct A feeding tube must follow the esophagus below the diaphragm into the stomach or intended enteral location. A tube that follows the tracheobronchial tree and ends in a bronchus is unsafe for feeding.
Easy analogy or mental picture Trace the tube continuously rather than jumping to its tip: airway placement follows the branching lungs, while enteral placement travels down the midline and below the diaphragm.
Memory hook A feeding tube that ends in the right bronchus must not be used.
NCLEX decision rule Before enteral feeding, verify the entire tube course and distal tip on the ordered confirmation study; do not use a tube that terminates in the airway.
Why the other choices are wrong A gastric bubble or lung edge may be visible, but the decisive hotspot is the misplaced tube tip and its abnormal course.
References
[1]
PMC: Chest radiograph evaluation of tubes and lines
[2]
PMC: Endotracheal tube placement on chest radiographs
Clinical situationBefore starting tube feeding, the nurse reviews this radiograph.
What the nurse should noticeThe enteral tube follows the tracheobronchial tree and terminates in the right bronchus instead of passing below the diaphragm into the stomach. Feeding must not begin.
Transfer to practiceBefore enteral feeding, verify the entire tube course and distal tip on the ordered confirmation study; do not use a tube that terminates in the airway.
Enteral tube — A tube intended to deliver nutrition into the gastrointestinal tract.
Bronchial placement — Misplacement of a tube within the tracheobronchial tree.