Enteral Nutrition

Question 1

Types of tubes

Answer 1

-Naso-Gastric (NG tube)
-Percutaneous Endoscopic Gastrostomy (PEG) Tube
-Gastrostomy Button (G-Button)

Question 2

Closed System

Answer 2

-most common
-system cannot be opened
-can safely hang for 24 to 36 hours

Question 3

Types of enteral nutrition

Answer 3

-Continuous
-Cyclic
-Intermittent
-Bolus

Question 4

Continuous Nutrition

Answer 4

-Administered over 24 hour period
-Initiate full strength formula at designated rate and gradually increase every 8-12 hours until goal rate reached
-HOB elevated 30º at ALL times

Question 5

Cyclic Nutrition

Answer 5

-Administered under 24 hour period
-HOB elevated 30º or greater during feed administration and for minimum of 1 hour after stop
-Pre and post-flush with 30mL sterile water

Question 6

Intermittent Nutrition

Answer 6

-Initial full strength formula at specified volume and increase gradually every 8-12 hours until goal volume reached
-Usually administered over at least 20-30 mins by enteral pump/syringe
-HOB elevated at least 30º for 1 hour minimum after each feed (elevated during and after!)
-Pre and post flush with 30 mL of sterile water

Question 7

Bolus Nutrition

Answer 7

-Syringe used to administer formula by gravity
-Administered more quickly than intermittent feeding
-HOB elevated at least 30º for 1 hour minimum after feed
-Pre and post flush with 30 mL of sterile water

Question 8

Gravity administration

Answer 8

-Ensure HOB 30º
-Connect device and administer via gravity flow- slowly!
-Flush with 30 mL sterile water
-Keep HOB elevated at least 1 hour

Question 9

Pump Administration

Answer 9

-Ensure HOB elevated at least 30º at all times
-connect PRIMED pump tubing
-Ensure pump rate as ordered
-Open clamp and start infusion
-Monitor gastric residual every 4 hrs IF signs of intolerance
-Flush per protocol (Common 30 mL)

Question 10

High Rish

Answer 10

-Aspiration
-Diarrhea
-Constipation
-N/V
-Gas, bloating, cramping
-Dehydration
-Hyperglycemia

Question 11

Signs and symptoms of Aspiration

Answer 11

-Cough
-Shortness of breath
-Raspy voice
-Gurgling

Question 12

Interventions for Aspiration

Answer 12

-STOP the feeding
-Elevate HOB at least 30-45º
-Notify physician
-Check placement with order

Question 13

Proceeding with feed

Answer 13

-Assess patients GI system (abdomen, bowel sounds, location of tube)
-Ensure patient in proper position (HOB elevated at least 30º)

Question 14

Metoclopramide (Reglan)

Answer 14

-Gastroporesis
-GERD
-N/V

Question 15

Ondansetron (Zofran)

Answer 15

N/V

Question 16

Nursing interventions

Answer 16

-Monitor for signs of intolerance
-Intake and output
-Daily weight
-Oral care
-Assess tubes for correct placement and proper labeling
-Don’t let tubing run dry
-Be aware of tubes during patient transfer or turns