GI ATI

BY: Saidel Elizondo

Enteral Feeding Tube

Delivery of a nutritionally complete feeding

directly into the stomach, duodenum, or jejunum
Used for total feeding as supplementation for
poor oral intake
3 types
Small-bore nasogastric feeding tube
Small-bore nasointestinal/jejunostomy tube
Percutaneous endoscopic gastrostomy (PEG)

Checking for
placement

Auscultating for placement is NOT considered

reliable
Use an x-ray to verify initial placement of the
nasogastric or nasointestinal tube
Gastric PH 1.5-4
Intestinal PH 6
Respiratory PH > 7
hold/stop feeding if residual >100 ml for
intermittent or continuous feeding; do Not return
residual

Small-bore nasogastric
feeding tube

X-ray for placement

Check PH before feeding or every 4 hours on
continuous feeding
Maintain semi-fowler while feeding
Replace tube every 4 weeks

Small-bore
nasointestinal/jejunostomy tube

Used to provide nourishment or to remove gas

and liquid drainage
X-ray
Assess length
Check residual volume greater indicates upward
migration

Ph 6
Maintain semi-fowler

complications

Refeeding syndrome can be life-threatening

Bleeding
Infection
Abdominal distention: N/V/D constipation
Hyponatremia, hyperkalemia

PEG tube

Assess
skin integrity
Residual volume
Allow feeding to infuse slowly ( by gravity)
Flush with 30 ml warm water before and after
feeding
Maintain Semi-Fowlers position 1 to 2 hr after
feeding

Parenteral Nutrition

IV administration hypertonic intravenous

solution (glucose, insulin, minerals, lipids,
electrolytes, and other essential nutrients)
2 types
Partial and total

Partial or Peripheral
nutrition (PPN)

Used client cannot take enough nutrients

PICC line or large distal arm vein

Total parenteral nutrition

(TPN)

intensive nutritional support for extended

periods of time
Central vein (can administer high levels of
glucose)
Used for solutions that contain hypertonic
glucose and amino acids, composed of
dextrose
Used with non-functioning GI tracts and those
who are NPO for >7days

Contributing factors

Severe burns
Chronic pancreatitis
GI mobility disorders
Short bowel syndrome
Malabsorption disorders

Nursing interventions

Monitor for infection from central line

Dressing change requires strict surgical asepsis every
27 hrs
Monitor for signs of systemic infection (aches, chills,
fever, nausea, vomiting, weakness)
Keep 10% dextrose/water available
Prevent air embolism
Change tubing every 24 hours
Monitor glucose, electrolytes, fluid balance
Monitor for fat overload syndrome (fat emulsions)
Fever, increased triglycerides, clotting problems and multisystem organ failure, discontinue infusion and notify
provider immediately
**Must be weaned off before discontinuing**

Resources

Axley, L. (2013). The comprehensive NCLEXRN review. Leawood, KS: ATI Nursing
Education.