ENT Nutrition Flashcards
What is Ent Nutrition?
Tube feeding, which is a method of delivering food to the body through the GI tract.
What are different types of tubes?
-Naso-Gastric (NG) Tube
-Percutaneous Endoscopic Gastrostomy (PEG) Tube
-Gastrostomy Button (G-Button)
Enteral Tube Indications
Cancer, Critical illness or trauma, Neurological or muscular disorders, GI Disorders, Respiratory failure with prolonged intubation, Inadequate oral intake.
Enteral Tube Indication-Cancer
Head and neck, upper GI, radiation
Enteral Tube Indication- Neurological or muscular disorders
Cerebrovascular accident, dementia, Parkinson’s
Enteral Tube Indication- GI disorders
Fistula, inflammatory bowel disease, pancreatitis
Enteral Tube Indications- Inadequate oral intake
Anorexia, dysphagia, severe depression
Enteral Tube Assessment
GI System-
Appearance of abdomen, bowel sounds, palpation, elimination patterns.
Enteral Tube-
Location, length, insertion site, patency
Enteral Nutrition- Closed system
Most common, System cannot be opened, can safely hang for 24 to 36 hours.
Enteral Nutrition- Open system
Prepared by nurse at the bedside, solution(s) added to empty system container.
4 types of enteral nutrition
-Continuous
-Cyclic
-Intermittent
-Bolus
Continuous Nutrition
-Administer over 24-hour period using pump
-Initiate at low rate and increase rate every 8-12 hours until goal rate achieved or patient intolerance
-HOB 30 degree or greater at all times
Cyclic Nutrition
-Administer under 24 hour period using pump often over night
-Patient may eat during break periods (check diet orders for restrictions)
-HOB elevated 30 degree or greater during feed administration and for minimum of 1 hour after stop
-Pre and post-flush with 30mL sterile water
Intermittent Nutrition
-Initiate at specified volume, and increase volume every 8-12 hours until goal volume or patient intolerance
-Administered over at least 20-30 minutes by pump or gravity
-HOB elevated 30 degree for 1 hour minimum after each feed
-Pre and post-flush with 30 mL of sterile water
Bolus Nutrition
-Administer Gravity
-Administer more quickly than intermittent feeding
-HOB elevated 30 degree or greater for 1 hour minimum after feed
-Pre and post-flush with 30mL of sterile water
ET Feeding Complications
-Pulmonary aspiration
-Diarrhea
-Constipation
-Nausea/vomiting, cramping
-Dehydration
-Tube occlusion
-Tube displacement
ET Feeding Interventions
-Pulmonary aspiration: Verify tube placement, HOB 30-45 degree, reassess gag reflex
-Diarrhea: Consider lower, continuous rate, isotonic formula, change feed bag and tubing Q24hr and PRN
-Constipation: Consider higher fiber formula, give water during flushes, assess ambulation status
-Nausea/vomiting, cramping: Lower rate, HOB 45 degree, lactose free, room temperature formula stop feed if GI obstruction
-Dehydration: Lower rate, isotonic formula, Increase free water
-Tube occlusion- Thoroughly crush and mix meds and shake formula can
-Tube displacement: Replace, confirm placement and secure properly
Pulmonary Aspiration
-Signs & Symptoms: Cough, Shortness of breath, Raspy Voice, Gurgling
-Intervention: If aspiration is suspected- stop the feeding, Elevate HOB at least 30-45 degrees, notify physician, check placement
What tools and techniques are used in placement verification?
-Gastric content pH test
-X-ray
-Tuber measurement
