1. Enteral Nutrition & Medications
NUR 152
Mesa Community College

2. Gastrointestinal Tubes
Nasogastric Tube
Gastrostomy (PEG)
(Percutaneous endoscopic)
G-button (after healed)
Jejunostomy
Placed in the
jejunum

3. Enteral nutrition Solutions Methods of Delivery Types of formulas
Blenderized
Polymeric
Monomeric
Types of formulas
Basic
↑ protein
Elemental
Diabetic
Renal
Pulmonary
Fiber-containing
Methods of Delivery
Bolus
Intermittent Drip
Continuous
Complications

4. Administering a Tube Feeding Volume 2, Procedure 27-3A
Using a calibrated plastic bag to administer a tube feeding. Using the barrel of a syringe to administer a tube feeding. Feeding set tubing with drip chamber. (Ross Products Division, Abbott Laboratories. Used with permission.)
Copyright 2008 by Pearson Education, Inc.

5. Administering a Tube Feeding Cont. Volume 2, Procedure 27-3

6. Nursing Process & Enteral Nutrition
Obtain a baseline weight, vitals & labs
Raise HOB at least 30 degrees (Semi-Fowler’s)
Assess tube security & placement
Aspiration & visualization of secretions &
re-installment of secretions
√ for pH < 6 (or per agency policy)
Assess tolerance to feedings
Check for residuals for continuous feedings every 4-6 hours (or depending on agency policy)
Residual feedings should not be more that ~ 100mL or agency policy
For intermittent feeding: no more than 50% of the previous feeding should remain

7. Nursing Process & Enteral Nutrition
Flush tube as indicated
Before administering feeding
Check expiration date
Warm feeding to room temperature
Hang the bag about 12 inches above insertion point, clamp tubing and add formula and then purge the tubing
Attach to patient tubing & regulate the drip rate
If syringe system, clamp tubing & add feeding to syringe, unclamp & slowly let in feeding
Remain in fowlers position for at least 30 min. after feeding completed

8. Nursing Process & Enteral Nutrition
Monitor urine output & bowels sounds & vital signs
Free water
Change feeding bag daily (every 24 hrs)
Always ensure client safety & comfort!
Don’t forget to document!

9. Enteral Medications
Most drugs administered orally can be given enteral
Medication is diluted with water
Placement of tube is confirmed
Medication delivered via gravity
Flushed with water
Care is taken not to insert large amounts of air

10. Knowledge √ Documenting Nutrition
The nurse has finished providing a tube feeding to a patient. The nurse should document all of the following except:
A. Duration of the feeding
B. Name of physician prescribing feedings
C. Solution provided
D. Patient’s tolerance of the feeding
E. Amount of the feeding

11. Documenting Nutrition 2
A patient receives several tube feeding each day. After documenting the patient’s assessment findings, and tolerance of the feeding, the nurse should also document the amount of feeding provided on the:
A. Dietary consultation notes
B. Intake and output record
C. Vital signs record
D. Nurses notes

12. Feeding Tubes
When feeding tubes are first positioned, verification is done by:
A. Auscultation
B. X-ray confirmation
C. pH testing of gastric contents
D. Confirmation of distal mark on feeding tube

13. Tube Feedings Which of the following best describes a “bolus feeding”?
A. Infusion of a feeding that is stopped for a specified time
B. Small amounts are continually infused over a specified time
C. Intermittent feeding of a specified amount of feeding at specified times
D. Free water infused in-between feedings