Enteral Tube Feedings
Enteral Tube Feedings- Enteral nutrition, also known as tube feeding, is a way of delivering nutrition directly to your stomach or small intestine.
- Nasogastric tube (NGT)
- Percutaneous endoscopic gastrostomy (PEG)
- Nasoduodenal tube (NDT)
- Low-profile gastrostomy device (LPGD)
Small Bowel Access-
- Nasal-jejunal tube (NJT)
- Percutaneous endoscopic jejunostomy (PEJ)
Types of Tube Feedings-
- Intermittent or bolus feedings- A set volume of formula is delivered at specified times.
- Continuous feedings-A set rate of formula is delivered over a period of time.
- Cyclic feedings- Similar to a continuous feeding but the infusion is stopped for a specified time within a 24-hour period, usually 6–10 hours.
Checking Tube Placement-
- Aspirate gastric contents and check pH.
- Gastric aspirate pH 1–4 but may be as high as 6 if patient is on medication to reduce gastric acid (famotidine, ranitidine, pantoprazole).
- Small intestine aspirate pH >6.
- Obtain chest x-ray.
- Inject 20–30 mL of air into the tube while auscultating over the epigastrium. Air in the stomach can be heard via a swooshing sound.
Feeding Tube Complications-
|Nasopharyngeal discomfort||Reposition tube.|
|Esophageal ulceration or bleeding esophageal varices||Consider PEG or PEJ tube.|
|Clogged tube||Flush with lukewarm water after every feeding. Hosp. Protocol|
|Tube displacemen||Reposition tube.|
|Stomal leak or infection||Keep area around stoma clean and dry.|
|Nausea, vomiting, cramps,bloating, abdominal distention||
|Diarrhea||Withhold or decrease amount, rate, and frequency of feedings.|
Dumping syndrome: nausea,vomiting, diarrhea, cramps,pallor, sweating, high HR
|Withhold or decrease amount, rate, and frequency of feedings.|
Checking for Residuals
- Assess every 4–6 hrs for continuous feeding and prior to bolus feeding.
- Using a 30- to 60-mL syringe, withdraw gastric contents from the feeding tube. Note volume of formula.