Enteral Feeding Systems and Nursing Assessment Flashcards

Vocabulary terms and clinical guidelines regarding enteral feeding systems, specialized formulas, and nursing procedures for tube placement verification.

Open System (Feeding)

A feeding system that uses an open-top container where formula is either ready to serve or requires reconstitution.

Closed System (Feeding)

Pre-filled containers commonly containing $1000\,mL$ of formula to which an enteral feeding tubing is attached using sterile technique.

Open Set Maintenance

Remaining formula should be discarded after $4/8\,h$; the set should be taken down, rinsed well, and rehung with new feeding.

Bag and Tubing Disposal

The standard timeframe in most institutions for discarding the bag and tubing is after $24\,h$.

Optimal Formula Temperature

Best served at room temperature to avoid abdominal cramps (if cold) or bacterial growth (if heated).

JEVITY

A formula with added fiber designed to reduce the incidence of diarrhea.

JEVITY PLUS

A formula with added fiber plus an indigestible CHO that helps maintain normal bowel function.

OSMOLITE

A high nitrogen formula used to moderately increase protein and caloric intake.

ProMod

A protein powder added to some enteral formulas.

ProMote

A specific type of high protein formula.

GLUCERNA

A formula designed for people with diabetes or abnormal glucose tolerance.

NEPRO

A formula high in calories and low in electrolytes for those requiring fluid and electrolyte restriction.

PULMOCARE

A high calorie ratio formula that is high in fat and low in carbs.

Nasogastric (NG) Placement Confirmation

Initial tube placement must be confirmed by x-ray before any feedings or substances are introduced.

Baseline Data (Tube Placement)

After x-ray confirmation, the nurse marks the tube at the exit point from the nose and records the length of visible tubing.

Whoosh test

The auscultatory method for verifying tube placement that should no longer be used.

pH Measurement (Gastric)

The recommended method for testing placement where a pH of $1-5$ is good for gastric contents ($4-6$ if on acid-inhibiting meds).

pH Measurement (Intestinal/Bronchial)

Intestinal aspirate typically has a pH of $6$ or higher; a pH of $6-8$ suggests bronchial placement.

pH Measurement Procedure

Draw $30\,mL$ of air to flush the tube, then obtain $5-10\,mL$ of aspirate to expel onto a pH strip.

Gastric Secretions Appearance

Secretions that tend to be grassy green, off-white, or tan in colour.

Intestinal Fluid Appearance

Fluid stained with bile that appears golden yellow or brownish-green.