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Feeding
Nutrition - is what a person eats and how the
body uses it.
Nutrients are organic and inorganic
substances found in foods that are required
for body functioning. Adequate food intake
consists of a balance of nutrients: water,
carbohydrates, proteins, fats, vitamins, and
minerals.
-three major functions: providing energy for
body processes and movement, providing
structural material for body tissues, and
regulating body processes.
Enteral Nutrition
(EN), also referred to as total enteral
nutrition (TEN), is provided when the
client is unable to ingest foods or the
upper gastrointestinal tract is impaired
and the transport of food to the small
intestine is interrupted. Enteral
feedings are administered through
nasogastric and small-bore feeding tubes,
or through gastrostomy or jejunostomy
tubes.
Enteral Assistive Devices:
Restlessness or agitation.
3. Gastrostomy and jejunostomy devices are
used for long- term nutritional support,
generally more than 6 to 8 weeks. Tubes
are placed surgically or by laparoscopy
through the abdominal wall into the
stomach (gastrostomy) or into the jejunum
(jejunos- tomy).
Materials:
NGT tube
Non-allergenic adhesive tape, 2.5 cm (1 in.)
wide
Sterile gloves
Water-soluble lubricant
Facial tissues
Bulb syringe
Stethoscope
Implementation:
Assist the client to a high Fowlers
position if his condition permits, and
support the head with a pillow.
Equipment
Measuring container from which to pour the feeding (if
using open system)
Water (60 mL unless otherwise specified) at room
temperature
Feeding pump as required /Asepto-syringe
Correct formula /feeding solution
Stethoscope
IMPLEMENTATION
Preparation
Performance
Prior to performing the feeding, introduce self and verify
the clients identity .Explain to the client what you are
going to do, why it is necessary, and how he or she can
participate. Inform the client that the feeding should not
cause any discomfort but may cause a feeling of fullness.
Perform hand hygiene
Provide privacy for this procedure if the client
desires it. Tube feedings are embarrassing to some
people.
Assess tube placement.
Assess residual feeding contents by aspirating all
stomach
contents and measure the amount before administering
the feeding. Rationale: This is done to evaluate
absorption of the last feeding; that is, whether
undigested formula from a previous feeding
remains. If 100 mL (or more than half the last
feeding) is withdrawn, refer first to
inter/resident on duty.
Rationale: At some agencies, a feeding is
delayed when the specified amount or more of
formula remains in the stomach.
Reinstill the gastric contents into the
stomach if this is the agency policy or
primary care providers order Rationale:
Removal of the contents could disturb the
clients electrolyte balance.
If the client is on a continuous feeding,
check the gastric residual every 4 to 6
hours or according to agency protocol.
Administer the feeding.
Before administering feeding:
Check the expiration date of the feeding.
Warm the feeding to room temperature.
Rationale: An excessively cold feeding may
cause abdominal cramps.
When an open system is used, clean the top
of the feeding container with alcohol
before opening it. Rationale: This
minimizes the risk of contaminants entering
the feeding syringe or feeding bag.
Syringe (Open System)
Remove the plunger from the syringe and
connect the syringe to a pinched or
clamped nasogastric tube. Rationale:
Pinching or clamping the tube prevents
excess air from entering the stomach and
causing distention.
Add the feeding to the syringe barrel.
Permit the feeding to flow in slowly at
the prescribed rate. Raise or lower the
syringe to adjust the flow as needed.
Pinch or clamp the tubing to stop the
flow for a minute if the client
experiences discomfort. Rationale:
Quickly administered feedings can cause
flatus, cramps, and/or vomiting.
If another bottle is not to be
immediately hung, flush the feeding tube
before all of the formula has run through
the tubing.
Instill 30 mL of water through the
feeding tube or medication port.
Rationale: Water flushes the lumen of the
tube, preventing future blockage by
sticky formula.
Be sure to add the water before the feeding
solution has drained from the neck of a syringe
or from the tubing of an administration set.
Rationale: Adding the water before the syringe
or tubing is empty prevents the instillation of
air into the stomach or intestine and thus
prevents unnecessary distention.
Clamp the feeding tube before all of the water
is