See Indications for enteral feeding. This article discusses types of enteral feeding tubes, methods, and formulas. It also reviews enteral feeding complications and describes related nursing care. People experiencing the physiologic stress of illness may have increased metabolic demands with reduced capacity to take in nutrition. Prolonged calorie restriction can lead to malnutrition.
Teresa,Williams health. Feeds can be administered via syringe, gravity feeding set or feeeing pump. Ensure tip of giving set is covered between uses. Am J Gastroenterol. Using a computerised literature search and an evidence-based classification system as described by the Joanna Briggs Institute for Evidence Based Nursing and Midwifery JBI Nursing care of feeding tube, a comprehensive review was undertaken of enteral tube management. To check the position of the tube nursing staff members need to have prepared the following equipment:. Dysphagia after stroke and its management. Juve-Udina, M. Consider providing education regarding expressed breast milk Breastfeeding support and promotion clinical guideline.
Nursing care of feeding tube. Distance Learning for Professionals
Prior to and after feeds nurses should adequately flush the enteral tube. Please remember that the Beauties and babes wallpaper of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. You are here: Nutrition. You will also be taught how to care for the PEG tube and the skin where the tube enters your body. Journal of Paediatric Surgery ; 6, Feeds and medications should only be administered via a TAT tube at the direction of the treating medical team. Please enter your comment! This may move the tube away from the wall Nursing care of feeding tube the stomach.
- PEG tube nursing care: Care must be taken when deciding to use, siting and managing percutaneous endoscopic gastrostomy tubes PEG tubes to avoid errors or complications that could prove fatal.
- Enteral feeding is the administration of essential nutrients and calories directly into the stomach or intestine via a feeding tube.
- A gastrostomy is a surgical opening into the stomach, made through an incision in the left, upper abdomen.
Enteral feeding is a method of supplying nutrients directly into the gastrointestinal tract. This guideline will use this term describe Orogastric, Nasogastric and Gastrostomy tube feeding.
A wide range of children may require enteral feeding either for a short or long period of time for a variety of reasons including:. It is imperative that nursing staff caring for children who have enteral tubes in understand why it is in-situ. For information regarding the Jejunal feeding and medication administration please see the Jejunal Feeding Guideline.
This guideline Video host erotic to support nurses in administering feeds and medications via tybe nasogastric, orogastric or gastrostomy tube in a safe and appropriate manner. Please note this guideline does not refer to the management Huge load in pants Jejunal tubes, for information regarding care of these please see the Jejunal Feeding Guideline.
Please note this guideline does not refer to the care of trans-anastomotic tube TATthese remain in-situ post-operatively and should not be removed or replaced. If the TAT is dislodged inadvertently, immediately notify the neonatal and surgical teams.
Feeds and medications should only be administered via a TAT tube at the direction of the treating medical team. Coughing, vomiting and movement can move the tube out of the correct position. The position of the tube must be checked:. Nursing staff should perform the following observations and obtain a gastric aspirate to establish tube position. Instead tube position should be initially confirmed via x-ray with clear documentation of NGT position marker.
To check the position of the tube nursing staff members need to have prepared the following equipment:. Some medications and formulas may affect the pH reading. If the patient is receiving a medication which is known to alter pH readings notify medical team, pharmacy and senior nursing staff, a clear plan Nutsing confirming the Nursing care of feeding tube position should be documented in the progress notes. If a reading greater than 5 is obtained, placement of the tube is questionable and it should not be used until the position of the tube is confirmed.
If a reading greater than 5 is obtained leave for up to 1 hour and try aspirating again. Small-bore tubes can be difficult to aspirate therefore the following are suggested techniques to try enhance the ability to obtain aspirate:. Correct placement of the tube should be confirmed prior to administration of an enteral feed by checking insertion site at the abdominal wall and observing the child for abdominal pain or discomfort.
If the nurse is unsure regarding the position of the gastrostomy or jejunostomy tube contact the medical team immediately. Feeds can be administered via syringe, gravity feeding set or feeding pump. The method selected is dependent of the nature of the feed and clinical status of the child. There is limited evidence available to support one method of feeding over the other.
Do not administer feeds through enteral tubes that are being used for aspiration or are on free drainage. An enteral feeding pump can be used intermittent, bolus or continuous administration of feeds, but is best suited for continuous feeding when tolerance to rate of feeding is an issue. Infinity pumps are now in use throughout RCH and the giving set can be primed by pushing the fill set button.
For further information regarding the use of the infinity pump please fesding the manufactures instructions. Please note: in most situations an IV syringe pump is not recommended for administration of enteral feeds and should not be used on the ward. If very small rates are required, consider using frequent syringe bolus feeding techniques as an alternative. For older children feeds given as a bolus should be removed from the fridge minutes before administration to bring them to room temperature.
Feeds given as a bolus may be warmed in an approved bottle warmer. This would be appropriate for all infants and older children who experience discomfort with cooler feeds. Continuous feeds should NOT be warmed. They may be pf from the fridge Keijiban adult prior to administration to bring it to room temperature and should not hung for cre than 4 hours — use the dose limit function on the feed pump to ensure this occurs.
Caution should be taken if titrating feeds up and down in patients with a metabolic condition. The decision for which type of enteral feed a child should receive should be made in consultation with the dietician, medical Naked lesbiana, nursing staff and family, taking into account the nutritional needs, clinical status and tolerance of feeds of the child.
Enteral feeds can be ordered from the RCH formula room. The family should be offered a dietician review while they are an inpatient to ensure the current feeding regime meets the ongoing nutritional needs of the child.
Consult your ward pharmacist or call Medicines Information ext: for advice on how to prepare a drug for enteral administration. Flushing is the single most effective action that prolongs the life of Nursijg tubes. Nurses should consider titrating feeds down or ceasing feeds feesing a short period of time depending on the clinical status and nutritional needs of the child. High acuity and intensive care patients may require management of Gastric Residual Volumes GRV to assist in management of gastric emptying delays, feeding intolerance, electrolyte balance and patient comfort.
Patients who have a non-functioning GIT i. Nursijg December The Royal Children's Hospital Melbourne. Enteral feeding and medication administration.
Enteral feeding and medication administration Od Aim Definition of Terms Assessment Management Adverse Effects Companion Documents References Evidence Table Introduction Enteral feeding is a method of supplying nutrients directly into the gastrointestinal tract. Aim This guideline aims to support nurses in administering feeds and medications via a nasogastric, orogastric or gastrostomy tube in a safe and appropriate manner. Gastrostomy tube - a feeding tube which is inserted endoscopically or surgically through the abdominal wall and directly into the stomach.
Once removed it may be returned to the patient or discarded. Trans-Anastomotic Tube TAT tube - Utilised after surgery to repair oesophageal atresia inserted by surgeons in the Neonatal patient population. Utilising pH indicator strips a reading of between should be obtained and documented. Small-bore tubes can be difficult to aspirate therefore the following are suggested techniques to try enhance the ability to obtain aspirate: Turn the patient onto their side.
This may move the tube away from the wall of the stomach. It will also clear the tube of any residual fluid. If a child belches immediately following air insufflation, the tip of the tube may be in the oesophagus Wait for minutes. This will allow fluid to accumulate in the stomach and try aspirating again. If it is safe to do so and the child is able to tolerate oral intake consider providing them with a drink and attempt aspirate in minutes If no aspirate obtained, advance the tube by cm and try aspirating again If aspirate not obtained discuss with senior nursing staff or medical staff and consider removing the tube or checking position by x-ray.
Gastrostomy tube Correct placement of the tube should be confirmed prior to administration of an enteral feed by checking insertion site at the abdominal wall and Why are girls such bitches the child fedding abdominal pain or discomfort.
The position of the tube Free big boobed cunt pictures to be checked 4 hourly with change of feeds It is recommended that the feed be ceased, withdraw aspirate and test pH. If reading greater than 5, cease the feed for 30 minutes, aspirate and test pH Should there be any dispute as to cade position of the tube, do not recommence feeds.
Discuss Neil diamond hard of gold senior nursing staff or medical staff. The following needs to be checked 2 hourly during the feed: Taping Marker on NGT Observe child for signs of respiratory distress. Check infusion hourly and document intake.
Flushing is not routine on the Neonatal unit and flushing with air is the preferred method. Enteral feeding tubes should be flushed regularly with water or sterile water if appropriate : Prior to and feedijg feeding Prior to, in-between and after medications Regularly in between tube use Modify flush volumes throughout as needed for infants and children with fluid restrictions — these patients may require minimal volume 0.
However in shorter tubes 1. Venting Feeding tubes may be used to facilitate venting or decompression of the stomach from the accumulation of air during such interventions as High Flow Nasal Prongs, Non-Invasive or Invasive Ventilation. Feeds Feeds can be administered via syringe, gravity feeding set or feeding pump. Consider providing education regarding tubw breast milk Breastfeeding support and promotion clinical guideline.
Administration of Feeds When preparing to administer feeds nursing staff must confirm the position of the enteral tube. Prior to and after feeds nurses should adequately flush the enteral tube.
If unable to Nursin up for a bolus feed or if receiving continuous feeding, the head of the bed should be elevated degrees during feeding and for at least 30 minutes after the feed to reduce the risk of aspiration. Using a syringe for a bolus feed Remove the plunger from the syringe and place the tip of the syringe into the enteral tube connector at end of the enteral tube. Holding the syringe and enteral tube straight, pour the prescribed amount tub feed into the syringe. Let it flow slowly through the tube e.
Pour the prescribed amount of water into the syringe and allow to flow through to flush the Nursing care of feeding tube tube appropriately. Using gravity feeding for bolus, intermittent feeds and continuous feeds.
Using a gravity feeding set with the roller clamp closed, attach the set to the feeding container with the correct Tentacle hentis amount of feed and hang the container Nursing care of feeding tube the carw.
Squeeze the drip chamber until it is one third full of the feeding solution. Remove the protective cap from the end of the giving set and open the roller clamp, allowing the feed to run down to the end of the giving set to prime the linethen close the roller clamp. Connect the giving set to the enteral tube connector at the end of the enteral tube.
Open the roller fube and set the Nursing care of feeding tube rate by counting the drops per minute. As a guide, 20 drops of standard feed is hube 1ml. Check the drip rate regularly to ensure the feed is still running at the required rate. Using an enteral feeding pump for bolus or intermittent enteral feeding An enteral feeding pump can be used intermittent, bolus or continuous administration of feeds, but is best suited for continuous feeding when tolerance to rate of feeding is an issue.
Completion of feed The tube must be flushed with water air in neonates to prevent tube from blocking see above. Giving sets: Rinsed out with warm water tap or sterile.
Ensure tip of giving set is covered between uses. Only prime the giving set with formula immediately prior to feeding time. The set should feexing changed every 24 hours or as per manufactures instructions.
Types of feeds The decision for which type of enteral feed a child should receive should be made in consultation with the dietician, medical team, nursing staff and family, taking into account the nutritional needs, clinical status and tolerance of feeds Look at xxxx the child. Do not administer drugs through tubes used for aspiration or on free drainage unless specifically directed by medical staff.
Confirm that the enteral feeding tube is the intended route for a medication before administration. Confirm the position of tuge enteral tube prior to medication administration see above.
Adequately flush the enteral tube before, in-between and after medication administration see above. Choice of drug preparation Consult your ward pharmacist or call Medicines Information ext: for advice on how to prepare a drug for enteral administration.
Enteral Feeding Nursing Care Plan – Imbalanced Nutrition, less than body requirements. Enteral feeding is the administration of essential nutrients and calories directly into the stomach or intestine via a feeding tube. It could help maintain caloric and nutritional requirements of an individual with difficulty in taking enough food orally. It Author: Maye Serrano R.N. Feeding Procedure Connect the syringe to the extension/adapter for bolus or the feeding bag tubing for continous/gravity feedings. Open clamp and allow to flow either turning on the pump or pouring formula into the syringe. If using gravity formula should not go in faster than over hour dependant on amount to be infused. Oct 12, · A proportion of these will require an enteral feeding tube to meet their nutrition requirements. Percutaneous endoscopic gastrostomy (PEG) tubes are long-term, artificial enteral feeding tubes that require endoscopic placement and allow direct access to .
Nursing care of feeding tube. Nasogastric Tube/Orogastric Tube- Checking the Position
Email Address. However in shorter tubes 1. If the nurse is unsure regarding the position of the gastrostomy or jejunostomy tube contact the medical team immediately. If a patient does not have any risk factors, PEG tube placement still has a risk of complications. However, be aware that no conclusive evidence shows that pausing tube feeding during repositioning reduces aspiration risk for patients with high GRVs. There are many advantages to PEG tube placement for long-term access to the gastrointestinal tract that bypasses the mouth and oesophagus. After the first 72 hours it is important to monitor the PEG tube and site at least daily and more often if concerned. The general indicators are symptoms of dysphagia or an inability to eat or drink enough to meet nutritional requirements Westaby et al, Giving sets: Rinsed out with warm water tap or sterile. PEG tube placement in patients with an infection is not advised and should be discussed by the multidisciplinary team. Feeds given as a bolus may be warmed in an approved bottle warmer. Published December Elimination of radiographic confirmation for small-bowel feeding tubes in critical care.
This article provides a brief overview of the most common types of enteral feeding tubes, their placement and the problems that may be encountered in the care of patients with tubes in situ.
See Indications for enteral feeding. This article discusses types of enteral feeding tubes, methods, and formulas. It also reviews enteral feeding complications and describes related nursing care. People experiencing the physiologic stress of illness may have increased metabolic demands with reduced capacity to take in nutrition. Prolonged calorie restriction can lead to malnutrition. Malnourished patients with inadequate caloric and protein intake may suffer emaciation, poor healing, and pressure injuries.