Today our topic of discussion is Procedure of Enteral Feeding.
Procedure of Enteral Feeding
Procedure (Fig. 28.45)
- Wash hands and put clean gloves
- Pinch proximal end of the feeding tube and elevate to 18 inches above the patients head.
- Fill the syringe with the required feed. Allow syringe to empty gradually, refill until prescribed amount has been given to the patient
- If continuous drip method is used hang the feeding bag to the pole above 18 inches above patients head and connect end of the bag to the proximal end of the feeding tube and set rate
- Regulate the drip rate to permit the formula to infuse over 20-30 minute by adjusting the height of the feeding bag or adjusting the rate of flow
- When the tube feedings are not being administered, clamp the proximal end of the tube
- Rinse the tube with plain water at the end of feeding
- Reclamp the gastric tube
- Remove gloves and wash hands.
Post-procedure Care
- Cover the end of the feeding tube with its plug or cap to prevent leakage and contamination of the tube
- Leave the patient in semi-Fowler’s or high Fowler’s position for at least 30 minutes
- Rinse all reusable equipment with warm water.
- Dry it and store it in a convenient place for the next feeding.
- Change the equipment every 24 hours or according to your facility’s policy
- The patient and family members are gradually included in these activities
- Weight is checked daily and watch for sudden gain in weight
- Observe for signs of dehydration (dry mucous membranes, thirst, and decreased urine output)
- Watch for possible complications
- Record amount of feeding, patient’s response to tube feeding and untoward effects in nurse’s notes and record intake in fluid balance chart.
Complications of Tube Feeding
- Mechanical: Nasopharyngeal, luminal obstruction, mucosal erosions, tube displacement, aspiration.
- Gastrointestinal: Cramping/distention, vomiting/diarrhea.
- Metabolic: Hypertonic dehydration, glucose intolerance, hyperosmolar nonketotic coma, hepatic encephalo- pathy, renal failure, cardiac failure.
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