Enteral and PN nutrition

what clients qualify for enteral tubes

must have at least partially functioning GI system

when are NG tubes used

times of higher caloric demand: burns, chemotherapy, radiation, or unable to chew/swallow.

how long are NG tubes used

3-4 weeks

measurement for NG tube

tip of nose to earlobe to xiphoid process

preparation for NG placement

look at nares, listen to bowel sounds, palpate abdomen, and position in high fowlers.

how to verify placement is correct

aspirate gastric content, test pH (4 or less), confirm by x-ray.

how to prepare for problems

may vomit, have basin ready, pause procedure when they start to vomit, make sure airway is clear.

removal of NG tube

measure/document drainage, assess color/consistency/odor, one swift movement, make sure its all in tact, abdominal assessment, pinch when removing, and know last bowel movement and next bowel movement and urine output

continuous delivery

over 24 hrs. Infusion pump. Critically ill clients.

continuous feeding might require

checking for residual every 4-6 hours: use large syringe and draw up whats left in clients stomach. Document how much you get.

if gastric residual is more than ___ mL on ___ consecutive measurements then hold feeding and call doctor. This could indicate delayed gastric emptying.

250, 2

tube should be flushed with ___ mL of warm water every ___ hours to maintain PATENCY and provide hydration.

30, 4

intermittent feeding

formula every 4-6 hours in equal portions. Infused over 30-60 minute period.

bolus feeding

usually 4-6 times a day via a large syringe attached to a feeding tube.

ostomies

long term, surgical creating opening (stoma), feeding directly to stomach or intestines. Used for high risk of aspiration/nasal obstruction.

two types of ostomies

gastrostomy (PEG tube) and jejunostomy (might fallow bowel obstruction)

raise HOB at ___ degrees during procedures and ___ minutes after feeding

30, 30-60

formula should be

at room temp

gastrointestinal problems

vomitting, diarrhea, and constipation

mechanical problems

tube becomes displaced. ensure it is in the right place by testing pH

metabolic problems

dehydration, malnutrition is not fixed, body is not absorbing feedings correctly. Hyperglycemia: high blood sugar.

refeeding syndrome

potentially fatal