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Administering Feedings Through Gastric and Enteric Tubes nursing checkoff
Terms in this set (21)
Checks the health record to determine that tube placement has been confirmed by radiography before the first feeding
Determines the type of feeding, rate of infusion, and frequency of feeding.
Checks the expiration date of the feeding formula.
Shakes the feeding formula to mix well.
Warms the formula to room temperature for intermittent feedings; for continuous feedings, keeps formula cool but not cold.
Prepares equipment for administration.
For an Open System With Feeding Bag:
a. Fills a disposable tube feeding (TF) bag with a 4- to 6-hour supply of formula; primes the tubing.
b. Labels the TF bag with date, time, formula type, and rate.
c. Hangs the TF bag on an IV pole.
For an Open System With Syringe:
a. Prepares the syringe by removing the plunger.
For a Closed System With Prefilled Bottle With Drip Chamber:
a. Attaches the administration set to prefilled bottle and primes tubing.
b. Hangs the prefilled bottle on an IV pole.
Elevates the head of the bed at least 30° to 45°.
Places a linen saver pad under the connection end of the feeding tube.
Dons procedure gloves
For the first feeding, after radiography, verifies tube placement by (see Clinical Insight 28-5):
a. Aspirating stomach contents and measuring pH.
b. Asking patient to speak.
c. Measuring the external length of the tubing.
d. For nasogastric tubes, but not for gastrostomy or jejunostomy tubes, can additionally confirm by injecting air into the tube and auscultating for "whoosh."
For subsequent feedings, aspirates and measures the gastric residual (except for jejunostomy tubes).
a. Connects the syringe to the proximal end of the feeding tube. Draws back slowly to aspirate contents.
b. Measures the volume of aspirated contents using a syringe (if volume is > 60 mL, uses a graduated container).
c. Reinstills aspirate unless the volume is more than the formula flow rate for 1 hour (or alternatively, a total of 150 mL). If the aspirate volume is more than the formula flow rate for 1 hour or 150 mL, notifies the primary care provider.
Flushes the feeding tube with 30 mL of tap water (for intermittent feedings).
Beginning the Feeding:
If Using an Infusion Pump:
a. Hangs the feeding and prime tubing (unless already done at step 6). Threads the administration tubing through the infusion pump according to the manufacturer's instructions.
b. Clamps or pinches off the end of the feeding tube.
c. Traces the tubing from the bag back to patient.
d. If a connector is needed, attaches it to the open end of the feeding tube and connects to the distal end of the administration tubing. If no connector is needed, attaches the distal end of the administration tubing to the proximal (open) end of the feeding tube.
e. Turns on the infusion pump; sets the correct infusion rate and volume to be infused.
f. Unclamps the tube and begins infusion.
If Using an Open System and Syringe:
a. Clamps or pinches off the end of the feeding tube.
b. Attaches the syringe to the proximal (open) end of the feeding tube.
c. Fills the syringe with the prescribed amount of formula.
d. Releases the tube clamp or "pinch," and elevates the syringe. Does not elevate syringe >18 inches (45 cm) above the tube insertion site.
e. Allows feeding to flow slowly (if too fast, lowers the syringe).
f. When the syringe is nearly empty, clamps the tube or holds it above the level of the stomach; refills the syringe; unclamps and continues feeding until prescribed amount is administered.
Begins the infusion: Opens the roller clamp on the administration tubing and regulates the flow to the prescribed rate.
When feeding is infused, proceeds as follows:
a. Infusion Pump
Turns off the pump, pinches the end of the feeding tube, and flushes with the prescribed amount of water.
b. Open System Syringe
Disconnects the syringe from the feeding tube, flushes the tube with approximately 50 mL of tap water.
c. Closed System With Prefilled Bottle With Drip Chamber
Turns off the pump or turns the roller clamp off. Disconnects the feeding tube from the administration tubing. Flushes the feeding tube with prescribed amount of water.
d. Continuous Feeding
Flushes the tube with the prescribed amount of water (typically 50-100 mL) every 4-6 hours.
Caps the proximal end of the feeding tube.
Keeps the head of the bed elevated at least 30°-45° for 1 hour after TF is infused.
Provides frequent oral hygiene and gargling
Procedure Variation for Jejunostomy Tubes:
Does not instill air into the tube or check for residual before feeding.
Procedure Variation for Gastrostomy Tubes and G-Buttons:
Cleans insertion site daily with soap and water. A small, precut gauze dressing may be applied to site.
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