Module 7 - Enteral Feeding Flashcards
Purpose Enteral Feedings
Enteral nutrition is giving nutrients via the gastrointestinal tract
- Client cannot ingest food (still able to digest/absorb nutrients)
Nasogastric feeding
Passes through the nose and into the stomach
Oral-gastric feeding
OG tube, tube passes nose and inserted orally into the stomach
Gastronomy feeding (PEG)
Passes through the skin and into the stomach
Jejunostomy (PEJ or J tube)
Passes through skin into the jejunum – the upper part of small intestine
Combination: Gastronomy/Jejunostomy Tube (G-J Tube)
Feeding tube has 2 openings - one that passes through the skin into the stomach and another that passes through the skin into the jejunum
Indications for Enteral Feeding
- Cancer
- Critical illness/trauma
- Neurological/Muscular disorders
- Gastrointestinal disorders
- Anorexia
- Severe depression
- Difficulty chewing/swallowing
What is Parenteral Nutrition?
Form of specialized nutrition support in which nutrients are provided intravenously
- Central venous catheter (CVC)
- Central venous access device (CVAD)
- Requires careful monitoring to prevent/treat metabolic conditions
Nursing assessments prior to Enteral Feeding
- Clients need/function
- MD’s order
- Allergies
- Bowel sounds
- Nutritional status
- Tube placement
- Weight
- Hydration
- Skin integrtiy
- Positioning
How do we verify placement of tube?
- X-RAY confirmation
- Auscultation
- Checking tube markings
Polymeric Formula
Milk based blended food prepared by staff/family
Modular Formula
Single macro-nutrients (protein, lipids, glucose) that is added to other foods
Elemental Formula
Contains predigested nutrients that are easier to absorb
Specialty Formulas
Designed to meet specific nutritional needs in certain illnesses
Complications of Enteral feedings
- Pulmonary aspiration
- Diarrhea
- Fluid overload
- Tube displacement
- Abdominal cramping/nausea
- Electrolyte imbalance
Pulmonary Aspiration Cause and Intervention
Unwanted materials entering the lungs: feeding tube displaced, supine position, reflex disease
Intervention:
- Verify/re-position tube
- Reassess position
- Lower rate of delievery
Diarrhea Cause and Intervention
Bacteria contamination, allergy, malabsorption
Intervention:
- Check expiry dates
- Delivery continuously but at lower rates
- Treat with antidirrhea medications
Constipation Cause and Intervention
Lack of fibre, water, and medication issue
Intervention:
- High fibre formulas
- Add water
- Stool softener
Enteral feeding client education
- Intake/output (electrolytes)
- Observe signs of intolerance (bloating, diarrhea, constipation)
- Tender abdomen
- Skin integrity
- Weight
- Respiratory status (SOB)
- Promote mouth care
- Monitor blood sugar
Gastric Residual
Volume of fluid in the stomach, it indicates if gastric emptying is delayed
Re-feeding syndrome
Sudden shift in electrolytes due to re-instituting nutrition ex) Patients with Anorexia, fasting, extreme dieting
What should you Record and Document for Enteral Feedings?
- amount of formula
- type of formula
- clients response/tolerance
- type of tube
- stoma site
- skin integrity
- bowel sounds
- side effects
- status of feeding tube
- after care/education
- diagnostic tests
Interdisciplinary resources for Enteral feeding patients
- Nutritionist
- Gastrointestinal specialist
- Feeding clinic
- Client’s medical chart
- Diagnostic tests
- OT
LPN responsibility regarding lab values and electoyles
- Record and Document
- Intervention
- Advise MD/charge nurse of any changes
- Care planning
