Today our topic of discussion is General Instruction of Enteral Feeding.
General Instruction of Enteral Feeding
General Instructions
- Patient receiving internal tube feedings should be in an upright position to avoids aspiration or reflux (Fig. 28.44)
- If the patient is ambulatory, he is encouraged to walk, since movement facilitates absorption of the feeding
- Fluid balance is carefully recorded to identify decreased intake or excessive diarrhea
- Feeding are delayed for 2 hours if gastric residue is greater than to 150 mL. If this amount persists, the physician is notified
- During the feeding monitor for signs of intolerance which includes cramping, diarrhea, nausea, vomiting aspiration, glycosuria, and diaphoresis
- Always check the placement of the tube.
- Gently aspirate gastric contents with a syringe, and measure the pH of the gastric contents
- If the feeding solution does not initially flow through a bulb syringe, attach the bulb and squeeze it gently to start the flow.
- Then remove the bulb. Never use the bulb to force the formula through the tube
- If the patient becomes nauseated or vomits, stop the feeding immediately
- During continuous feedings, assess the patient frequently for abdominal distention
- Flush the tubing by adding about 50 mL of water to the gavage bag or bulb syringe.
- This maintains the tube’s patency by removing excess formula, which could occlude the tube
- If the patient develops diarrhea, administer small frequent, less concentrated feedings to administer bolus feeding over a long time- Drugs can be administered through the feeding tube Except for enteric coated drugs.
Preliminary Assessment
- Check the doctor’s order.
- Type of formula.
- Time, frequency amount of feeding .
- Specific indications for the client.
Preparation of the Patient and Environment
- Explain procedure to patient .
- Ask patient for any history of allergies
- Auscultate for bowel sounds before feeding
- Check placement of gastric tube by means of aspiration of gastric juice is by checking with stethoscope while introducing air into the stomach
- Position patient to high Fowler’s position or elevate head if bed 30 degrees
- Place a towel under the chin
- Examine the appearance of aspirated contents.
Equipment
- A clean tray containing:
- Large volume syringe
- Required feed a fluid
- Kidney tray
- Stethoscope
- A glass with water for flushing the tubing
- Continuous infusion set in continuous drip method isordered
- Towel
- Disposable gloves
- Measured glass to measure the fluid intake.
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