About Tube FeedingIf you cannot eat sufficient quantities of food to meet nutritional needs, then feeding can be given through a tube into the stomach or small bowel to provide adequate nutrients. There are a variety of tube feeding formulas on the market which are designed to meet 100% of your nutritional needs. The feedings may be given continuously over several hours, around the clock at a specific rate, and delivered by a special pump or several times a day in measured amounts. Adequate nutrition depends on the right type and amount of formula. Your healthcare provider will prescribe your feeding schedule, formula and amount of water needed for optimal nutrition and hydration. Show
After a brain or spinal cord injury, the metabolic rate may be increased and energy and protein needs may be high to provide nutrients for healing. Muscle atrophy is also common because of decreased mobility during this time. Calorie and protein needs tend to decrease a few months after injury, so tube feedings may need to be adjusted to avoid unwanted weight gain. It is important to monitor your body weight and know your weight goals. If you have significant weight changes (gain or loss of more than 2 lbs in 1 week) or if you are cleared to eat by a Speech Language Pathologist, contact your doctor, home health company, or registered dietitian for a tube feeding adjustment. Types of Feeding Tubes
You may see an adapter such as the Dale Ace connector Tube Feeding Preparation
Supplies to Gather:
Positions for receiving tube feedings:
How to check gastric residual (PEG feedings only):"Residual" refers to fluid/contents that remain in the stomach. Only those fed through a PEG tube should have a residual.
Note: If using a PEG, it is important to check tube feeding residuals every 4 hours while receiving continuous feedings and right before bolus feedings. Cleaning the Tube Site and Equipment
Mouth Care:
Troubleshooting Feeding TubesRecognition:
Causes:
Prevention:
What do I do when I have a clogged tube?
Recognition:
Causes: 1. Mechanical problem
2. GI problems
3. Side effect of medication or other treatments 4. Problem with formula
5. Offensive odors, sight and smell of food Prevention:
Immediate Action:
Recognition:
Causes:
Prevention:
Immediate Action:
Recognition:
Causes:
Prevention:
Immediate Action:
Recognition:
Causes:
Prevention:
Immediate Action:
Call your physician if any of the following occurs:
When checking residuals from tube feeding you collect 200 mL of residuals What is your best next action?If using a PEG tube, measure residual every 4 hours (if residual is more than 200 ml or other specifically ordered amount, hold for one hour and recheck; if it still remains high, notify doctor). If using a PEG tube, reinstall residual.
When gastric residual exceeds 250 mL for each of two consecutive assessments the nurse should do what?Do not administer feeding when a single gastric residual volume exceeds 500 mL or when two consecutive measurements (taken 1 hour apart) each exceed 250 mL because of the potential for aspiration.
How do you calculate tube feeding rate?If the feeding order is written with dose and time, you must determine the rate. Divide dose in mL by time in hrs to determine the rate. Rate is the amount of liquid food you give in one hour. Rate is measured in mL/hr (milliliters per hour).
How do you do continuous tube feeding?Turn the pump to STOP/OFF.. Close the clamp on the feeding bag tubing.. Pour the prescribed amount of liquid food into the feeding bag.. Hang the feeding bag on the pole above the pump. Make sure the bag tubing hangs straight.. Open the clamp slowly. ... . Close the clamp on the tubing.. |