Introduction to Home Tube Feeding

Summary

This video educates viewers on managing home tube feedings for individuals with special nutritional needs. It covers different types of feeding tubes, proper feeding techniques, tube care, and potential side effects. The video also discusses methods like bolus and continuous infusion feeding, flushing procedures, medication administration, and checking gastric residuals. Additionally, it provides tips for mouth care, managing side effects, and emphasizes the importance of following medical advice for a successful tube feeding experience.

Takeaways

• 🍼 **Types of Feeding Tubes**: There are three types of feeding tubes: Nasal Enteric (NG or NJ), Gastrostomy (PEG), and Jejunostomy (J-tube).
• 📝 **Tube Prescription**: A registered dietician will explain the tube prescription, including the formula name, daily amount, feeding schedule, and extra water needed.
• 💧 **Feeding Methods**: Two methods are used for tube feeding: Bolus feeding (larger amounts, 3-6 times a day) and Continuous Infusion (using a pump, 8-24 hours).
• 🧪 **Formula Storage**: Unused formula should be stored in a covered container in the refrigerator and discarded after 24 hours if opened.
• 🚿 **Flushing the Tube**: Flush the feeding tube with lukewarm water before and after feedings to prevent clogging and provide necessary fluids.
• 💊 **Medication Administration**: If unable to swallow, medications can be given through the tube, but should not be mixed with feeding formula unless instructed by a doctor.
• 🔍 **Checking Residuals**: Checking the amount of gastric fluid left in the stomach is important to ensure proper stomach emptying, especially before each feeding.
• 🩹 **Tube Site Care**: Daily cleaning of the tube site is crucial to reduce infection risk, and dressings should be changed as needed.
• 🌡️ **Potential Side Effects**: Be aware of side effects like diarrhea, constipation, nausea, and aspiration, and take appropriate steps to manage them.
• 📚 **Instruction Booklet**: A tube feeding instruction booklet is provided for reference, summarizing all discussed points and tailored to individual needs.

Q & A

What are the three types of feeding tubes mentioned in the script?

The three types of feeding tubes mentioned are: 1) Nasal enteric feeding tube (NG tube or ND/NJ tube), 2) Gastrostomy tube (commonly PEG tube), and 3) Jejunostomy tube (J tube).

What is the difference between a bolus feeding and continuous infusion feeding?

Bolus feeding involves receiving a larger amount of formula three to six times per day, with each feeding lasting 15 to 20 minutes. Continuous infusion uses a pump to control the flow of formula into the tube, lasting from 8 to 24 hours, sometimes referred to as cycled feedings.

How should unused formula be stored and what should be done with formula that has been open for more than 24 hours?

Unused formula should be stored in a covered container in the refrigerator. Any formula that has been open for more than 24 hours should be discarded.

What is the proper position for receiving a tube feeding, and how long should this position be maintained after a bolus feeding?

The proper position for receiving a tube feeding is sitting, if possible. If in bed, the head of the bed should be raised to at least a 45-degree angle. This position should be maintained for at least an hour after a bolus feeding and throughout the night for continuous or cycled feedings.

How often should the feeding tube be flushed and what is the purpose of this?

The feeding tube should be flushed before and after each feeding and while giving oneself medicine. The purpose of flushing is to prevent tube clogging and to provide extra fluid that the body needs.

What should be done if medications need to be taken through the feeding tube?

If medications are in liquid form, they can be injected into the feeding tube using a syringe. If medications are in pill form, they must be crushed to a fine powder or dissolved in warm water first. After administering the medication, flush the tube with a small amount of water to ensure all medicine is given and to prevent clogging.

How can one unclog a feeding tube and what steps should be taken?

To unclog a feeding tube, disconnect it from the bag, attach a syringe, and flush the tube with 30 to 50 milliliters of warm water. Apply mild pressure and gently pull back and forth on the syringe. Repeat this several times. If the clog persists, contact a dietitian for further methods.

What is a residual and why is it important to check it?

A residual is the amount of gastric fluid left in the stomach between feedings. It is important to check the residual to ensure the stomach is emptying properly, which can be done before each feeding through a PEG tube.

How should the site around a gastrostomy or jejunostomy tube be cared for to reduce the chance of infection?

The site around a gastrostomy or jejunostomy tube should be cleaned daily with mild soap and water in a circular motion. If there is a dressing on the site, it should be changed daily or when wet or dirty.

What are some potential side effects of tube feeding and what steps can be taken to address them?

Potential side effects include diarrhea, constipation, nausea, aspiration, dehydration, and abdominal discomfort. Steps to address these include adjusting the rate of feeding, increasing physical activity, using more water flushes, checking for signs of dehydration, and contacting a doctor for persistent issues.