Enteral feeding nursing responsibilities

ENTERAL NUTRITION

Purpose of enteral nutrition is to supplement the oral intake not to take the place of but to supplement the oral intake and to help provide total nutritional support. There are a lot of nursing responsibilities that we should do with this one.

1.Use small bore tube when giving NGT use 10 french or less
2.Check the pH of the gastric contents
3.Check tube placement.

a. X-ray – is the best or indication for tube placement especially if using Levine tube that has little mercury at the end.

b. Aspirate the content and check the pH and put back the aspirate.
c. Inject air and auscultate over the gastric area for sounds of the air you just put in.

4.Administer tube feeding at room temperature. Rationale: too cold will cause hypothermic shock.

5.Do not give the food that is hung more than 4 hours. Rationale: it gets sour and the stool will cause sour smell.

6.If the patient is to have 60 cc per hour you just hang 240cc.

7.If patient is in continuous feeding you hang it for 4 hours if it is consumed monitor residual. If the residual is more than 100cc-150cc it indicates delayed gastric emptying and you need to tell the doctor about it.

8.If patient is on feeding every 4 hours then it is not consumed you give some more you just check the residual and also check the pump if on continuous pump feeding.

9.During the feeding position the head of the bed should be elevated 30 degrees and until 1 hour after. If the patient is on continuous feeding the bed elevation should stay on 30 degrees.

10.Feeding set should be changed every 24 hours.

11.Check residual every 4 hours and rinse the bag out. Rationale: you don’t want the ensure or osmolite that is in to sour up.

12.If the patient has 6-tube either gastrostomy or jejustomy tube you need to skin skin around for signs and symptoms of infection.

13.Do not mix medications with enteral feeding. You crush the medication, diluted in warm water.

14.When to flash the tube? NCLEX Question

• Before and after every medication administration
• Before and after change of tube feeding.
• After checking for residual volume
• Every 4 hours during continuous feeding.
Rationale: by flashing the tube you maintain the patency of the tube.

15.Give the patient water. Rationale : because the tube feeding is hyperosmolites or thick, it pulls fluid out of the cells and dehydrate the patient that will to kidney failure. The blood becomes viscous and fluid with sugar, so it is important to give patient water.