Enteral Nutrition Administration

Summary

This instructional video outlines the process of administering enteral feeding to a patient with a nasogastric (NG) tube. It emphasizes the importance of verifying the tube's correct placement in the stomach through pH testing or X-ray, and measuring the tube's length to ensure it hasn't moved. The video also covers gastrointestinal assessment, checking for allergies, and using a 60cc syringe for feeding. It demonstrates how to flush the tube with sterile water for patency, administer the feeding solution by gravity, and clamp the tube after to prevent backflow. Post-feeding, it advises waiting before suction to avoid losing the feeding, and the necessity of documenting the procedure and patient's response.

Takeaways

• 🔍 Ensure the NG tube is correctly placed in the stomach before feeding by verifying with methods such as pH testing or X-ray.
• 📏 Measure the NG tube from the nose to the insertion point and document this to ensure consistent placement.
• 👂 Perform a gastrointestinal assessment, including listening for bowel sounds and checking for patient discomfort or allergies.
• 📋 Double-check the provider's orders and verify the correct tube feeding formula against the MAR.
• 🧼 Practice good hygiene by washing hands and wearing gloves before handling the NG tube.
• 💧 Use a 60 CC syringe to flush the tube with sterile water to check for patency and to prevent clogging.
• 🚫 Avoid using small syringes due to pressure gradients; a 60 CC syringe is recommended.
• 🍼 Administer the tube feeding formula by gravity, ensuring the tube is unclamped during the process.
• 🔄 Always flush the tube before and after administering feedings to maintain patency.
• ⏱ Wait at least 30 minutes to an hour before connecting the patient to suction after feeding to prevent the feeding from being sucked back out.

Q & A

What is the primary focus of the skill being discussed in the script?

The primary focus of the skill being discussed is how to provide a patient with enteral feeding using a nasogastric (NG) tube.

Why is it important to verify the placement of an NG tube before administering feeding?

It is important to verify the placement of an NG tube before administering feeding to ensure that the tube is still in the correct spot in the stomach, preventing potential complications such as aspiration.

What are the two methods mentioned for verifying the placement of an NG tube?

The two methods mentioned for verifying the placement of an NG tube are pH testing and measuring the tube from the nose to the point of insertion after confirming placement with an X-ray.

Why is it necessary to measure the length of the NG tube after verifying its placement?

Measuring the length of the NG tube after verifying its placement helps to ensure that the tube has not moved and remains in the correct position for each feeding, which is crucial for proper administration of enteral nutrition.

What is a gastrointestinal assessment, and why is it performed before administering an NG feeding?

A gastrointestinal assessment involves listening to bowel sounds and checking for symptoms like bloating, cramping, or diarrhea. It is performed to ensure the patient's gastrointestinal system is ready to receive the feeding and to prevent complications.

Why is it important to check the patient's ID and allergies before administering a tube feeding?

Checking the patient's ID and allergies is important to ensure that the correct patient receives the feeding and to avoid administering any substances that the patient may be allergic to, which could cause adverse reactions.

What is the significance of using a 60 CC syringe for administering enteral feedings?

Using a 60 CC syringe is significant because it helps to manage pressure gradients and ensures that the feeding is administered smoothly without causing discomfort or harm to the patient.

Why is it recommended to flush the NG tube with water before and after administering a feeding?

Flushing the NG tube with water before and after administering a feeding ensures that the tube remains patent and clear of any obstructions, preventing complications and ensuring the proper delivery of nutrients.

How does the process of administering a tube feeding by gravity differ from using a pump?

Administering a tube feeding by gravity involves pouring the feeding solution into the tube and allowing it to flow naturally, while using a pump involves a mechanical device that controls the rate and volume of the feeding.

Why is it advised to wait before attaching the patient to suction after a tube feeding?

It is advised to wait at least 30 minutes to an hour before attaching the patient to suction after a tube feeding to allow the nutrients to be absorbed and to prevent the feeding from being suctioned out, which would negate the purpose of the feeding.

What steps should be taken after administering a tube feeding to ensure the patient's comfort and safety?

After administering a tube feeding, the nurse should ask the patient about any discomfort, document the feeding, ensure the bed is lowered and alarms are set, and provide the call light and tray table within reach to ensure the patient's comfort and safety.