Enteral Nutrition Flashcards
Upper GI Tract
Esophagus, Stomach, Duodenum
Lower GI Tract
Most of the small intestine and the entire large intestine.
Who requires enteral nutrition
- Swallowing disorders, certain bowel diseases, and the malnourished.
- Functioning GI Tract
Open system
No greater than 4 hours
Closed system
24-48 hours
Nasogastric (NG) tube
Levin: small bore, single lumen
Salem Sump: large bore, double lumen
Dobhoff (nasoenteric): longer, small bore
Gastrostomy Tubes
PEG: Nutrition is delivered through to the stomach through the abdominal wall
G button or Mic-Key button: level with the skin, inserted through abdominal wall into the stomach
Enteral nutrition feeding schedules
Continuous
Gravity
Cyclic
Intermittent
Continuous
constant distribution of nutrition evenly over 24 hours
Gravity
continuous, no precise rate, maximum height of 18 inches above insertion site
Cyclic
regularly, less than 24 hours
Intermittent
regular/periodic (30-60 minutes), bolus method ( over 5-10 mins)
Enteral Nutrition Feeding
Head of Bed (HOB) should be elevated to semi-fowler’s position (30-45°)
Complications
- Aspiration
- Bacterial Growth
- Diarrhea, Nausea, Vomiting
Nursing assessment
- Abdominal Assessment
* Confirm length of tube
Verify tube placement
- VERIFY VERIFY VERIFY
- Gastric Residual Volume (GRV)
- Aspirate gastric contents and observe appearance
- Check pH of the contents using nitrazine paper
Gastric
1 - 5.5 pH
Gold standard
Obtain an X-RAY after initial insertion
Subsequent feedings: More than one bedside method.
•Most facilities have policies in place regarding amount of residual
-Greater than 150 ml or greater than flow rate for 1 hour needs attention
•Re-instill the residual contents you aspirated back into the tube
-Depends on amount of residual & hospital policy (be familiar with hospital policy)
Crushed meds via NG/PEG tubes
Dissolve powder in 20mL of water
Giving several meds via NG/PEG tube
give each separately flushing with 20 to -30 mL water in between
Prior to medication administration via enteral tube
Flush tube with 20 to 30 mL. of water
ALERT
- A: Aseptic technique
- L: Label enteral equipment
- E: Elevate the head of bead
- R: Right patient, Right formula, Right tube
- T: Trace all lines back to patient
Troubleshooting
- Prevention to maintain tube.
* Unless directed by healthcare professional do not use acidic solutions. Ex. Coca Cola
feedings. The nurse knows to do which of the following when administering medications via an NG tube?
Administer each medication separately.
