The patient is admitted with facial trauma, including a broken nose, and has a history of esopha-geal reflux and of aspiration pneumonia. Given this information, which of the following tubes is appropriate for this patient?
a. Nasogastric tube
b. Percutaneous endoscopic gastrostomy (PEG) tube
c. Nasointestinal tube
d. Jejunostomy tube
ANS: D
Patients with gastroparesis or esophageal reflux or with a history of aspiration pneumonia may require placement of tubes beyond the stomach into the intestine. The nasogastric tube and the PEG tube are placed in the stomach, and placement could lead to aspiration. The nasointestinal tube and the nasogastric tube may be contraindicated by facial trauma and the broken nose. The jejunostomy tube is the only tube in the list that is beyond the stomach and is not contraindicated by facial trauma.
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