enteral feeding methods

Question 1

Bolus

Answer 1

a health-care provider-ordered volume of formula is administered at set intervals throughout the day. To administer a bolus feeding, a large irrigating syringe (50 mL or greater) is attached to the feeding tube.

Question 2

continuous

Answer 2

-infusion pump at a constant rate over an 8- to 24-hour period.
-critically ill patients because of the decrease in hypermetabolic response to stress, the risk for aspiration, and the incidence of diarrhea.
-Continuous feedings should be interrupted every 4 hours to check placement and residual volume, to administer water for hydration if ordered, and to flush the tube to prevent clogging

Question 3

residual volume check

Answer 3

-Aspirate contents through the tube until the stomach is empty.
-If residual amount is greater than the syringe can hold, measure the aspirate volume using a graduated container.
-Do not discard the residual aspirate, as it is rich in electrolytes and should be reinstilled into the stomach to prevent an electrolyte imbalance unless health-care provider’s orders state otherwise.
-Determine whether the residual volume exceeds the health-care provider’s order for the amount at which to withhold the feeding.
- If the health-care provider does not write specific orders for handling residuals, then follow the facility’s policy and procedure.

Question 4

Nursing Responsibilities for a Patient with a PEG Tube or J-Tube

Answer 4

-Assessing tube placement by checking the tube markings to determine that the tube has not shifted or dislodged prior to each instillation
-Maintaining patency of the tube
-Performing daily assessment of skin integrity surrounding the tube
-Performing daily cleansing of the tube insertion site as appropriate
-Assessing bowel sounds daily, noting absent, hypoactive, or hyperactive sounds
-Assessing the abdomen, noting distention
-Assessing for gastric residual prior to instillation of medications or formula
-Elevating the head of the bed during feedings and for 30 to 60 minutes afterward
-Monitoring intake and output to ensure proper balance
-Monitoring weight, noting any loss
-Monitoring for diarrhea or constipation that might result from certain feeding formulas

Question 5

complications with tube feedings

Answer 5

-nausea and diarrhea
-clogged tubes
-aspiration
-metabolic problems
-contamination of formula

Question 6

managing feeding formula tips

Answer 6

Wash hands throughly
Rinse and wipe the top of the can before opening.
Label all opened formula with the patient’s name, date, and time when opened; follow the label instructions regarding the length of time you may use the formula once opened.
Make sure all open cans are covered and stored in the refrigerator when not in use.
Do not use and discard all unlabeled formula and out-of-date formula.
Rinse the feeding bag and tubing with clean water before adding new formula.
Flush the tube with water before and after each use.
Hang only the amount of formula that can be administered in 6 hours; discard formula that hangs for more than 6 hours.
Never add new formula to old.
Change the feeding bag and syringe every 24 hours.

Question 7

Partial parenteral nutrition

Answer 7

-inserted central catheter inserted into a smaller peripheral vein.( iv nutritional therapy )

Question 8

-Total parenteral nutrition (TPN)

Answer 8

administered through a central venous catheter (CVC) placed in a larger central vein
-differences between TPN and PPN are the vessel selected to receive the nutrition and the concentration of solution infused. Only the “least hypertonic” solutions may be infused into the peripheral veins, it’s possible to deliver higher concentrations through the larger central veins.

Question 9

monitoring nutritional status

Answer 9

-daily weights
-certain laboratory results
-electrolyte levels
-pre albumin , albumin , and total protein
-glucose