Assisted Feeding Flashcards
when will a feeding tube be considered for a patient?
if patients aren’t able or willing to eat spontaneously
what nursing interventions can be used before placing a feeding tube?
avoid food buffets in kennels (one type at one time for a short time) avoid prescription to avoid foo aversion try different textured foods ask if the patient can be given anti-emetic medication discuss appetite stimulants TLC offer food away from the kennel analgesia (if painful) offer usual diet and favorite treats warmed food prokinetic medication is the condition worsening and can clinical signs be improved?
how long should a patient be anorexic for before a feeding tube is placed?
48 hours or more
when is a feeding tube placed?
a patient has been anorexic for 48 hours or more
if the vet anticipates the patient to be anorexic after a surgical procedure
if there is trauma to the mouth, head or neck
to administer precise oral rehydration or medicine for patients with AKI
what are the 3 types of feeding tube?
naso-oesophageal
oesophageal
percutaneous endoscopic gastrotomy tube (PEG)
what equipment is needed to place an N/O tube?
surgical stapler feeding tube of correct size syringes that fit the feeding tube local anaesthetic sterile lubricant gloves sterile water tape
what sizing is used for N/O tubes?
french gauge
what local anaesthetic is often used when fitting N/O tubes?
Proxymetacaine
how should an N/O tube be placed?
LA into nose and maybe eye
lubricate tube
push into nose quickly and medioventrally
push tube in gently until you reach the measured mark
when happy tube is correctly placed secure with tape and either superglue or staple to nose and head
where should the N/O tube be measure from and to in cats and dogs?
7th rib in cats and 8th/9th ribs in dogs up to the tip of their snout
how can you check that an N/O tube is correctly placed?
attach syringe to end and check for negative pressure
if negative pressure slowly administer 10mls of sterile water watching for signs of respiratory distress
describe how to administer an N/O tube feed
calculate required amount of food
wear non-sterile gloves
draw up the required amount of food into an appropriate syringe(s)
pre-warm food within syringes in a water bath
check for negative pressure
administer 10mls water as flush
administer food slowly (over 10-15 mins)
watch for signs of nausea or regurgitation
administer 10mls of flush after
over how long should N/O feeds be administered?
10-15mins
what should you do if you see signs of nausea or regurgitation during N/O tube feeds?
slow down or if marked stop feed and try again in half an hour
what are the main nursing considerations of a patient with an N/O tube?
keep face and muzzle clean
tempt with food before every feed
take buster collar off for walks if putting it back on is tolerated well
avoid food buffet in kennel
avoid offering any prescription diets as this can create aversion
how long can NG tubes be used for?
up to 7 days
how is an N/O tube removed?
remove staples from the patient or peel away the tape
use no-sterile gloves to pull the tube gently out of the patients nose
which conditions will contraindicate and N/O tube?
cat flu congestion rhinitis head trauma epistaxis oesophageal disease marked regurgitation persistent vomiting impaired gastric outflow patients who are comatose or have limited gag reflex due to risk of aspiration if nutritional support needed for more than 7 dyas
what are the complications of N/O tubes?
patients removing own tube
not getting negative pressure before a feed - tube displaced
infection
reluctance to eat due to irritation from tube
aspiration
large dogs requiring very large feeds due to small lumen
blockage
what equipment is needed to place and oesophageal feeding tube?
oesophageal feeding tube (correct Fr) sterile gloves non-sterile gloves curved artery forceps surgical prep equipment (clippers scrub and drape) scalpel blade bandage material
