Question

Skill name:: Administering Enteral Feedings by Nasoenteric Tube

All questions must be answered based on the skill listed above:

what is the Description of this skill?

what are the indications?

what are the nursing interventions (pre, intra, post)?

what are the outcomes/evaluation?

what is the client education for this skill?

what are the potential complications?

what are the nursing interventions?

Answer 1

ANSWER

   Enteral feeding by NG tube.

       * Description of skill.

                 * It is a method of administration of feed directly into the stomach through

                   the nose.

       * Indications.

                * Patient with obstruction of esophagus.

                * Head and neck injury.

                * Coma.

                * Poor oral intake.

                * Anorexia nervosa.

                * Burn or cancer patient with increased metabolic needs.

                * Recurrent episodes of aspiration.

     Nursing interventions.

               Pre procedure care.

                   * Identify the patient explain procedure to patient.

                   * Assess for time of last feed,food allergies,bowel sounds and

                     lab values.

                   * Place the patient in fowlers position to prevent risk of aspiration.

                   * Wash hands and don gloves before the procedure to prevent

                     transmission of microorganisms.

                   * Spread makintosh and towel over patient chest to patient and bed

                      from soiling.

             Intra procedural care.

                   * Aspiration of stomach content and if it exceed 100ml for intermittent tube

                     feeding with hold the feed and notify physician..

                   * After the tube placement is confirmed pinch the feeding tube to prevent air

                     enter into stomach and attach barrel of feeding syringe to tube.

                   * Syringe barrel fill with water and allow fluid to flow in by gravity through raise

                     barrel above the level of patien head.

                   * Give feed through syringe barrel and allow it to flow by gravity and pinch the tube

                      whenever required to stop when pouring.

              Post procedural care.

                   * After administration of feed flush the tube with 30 cc of plain watwer to prevent

                     clogging of tube.

                   * After flushing close the end of the tube to prevent leakage.

                   * Keep the head of the bed elevated 30 to 40 minute after feeding to prevent aspiration.

                   * Wash hands and document type,amount of feed,patient tolerance in nurses record.

     Outcomes /evaluation.

   * Evaluate the patient after feeding through

* Monitor breath sounds.

* Bowel sounds.

* Diarrhoea.

* Constipation.

* Intake output chart.

* Gastric distension.

* Signs of aspiration.

   Patient education for this skill.

   * Educate the patient that make sure tube end is always closed after

feeding otherwise it cause leakage of feed.

                    * Continue fowlers position around thirty minutes after feeding to prevent

                       risk of aspiration.

                    * Immediately notify the nurse if experiencing sensaton of fullness,nausea

                       vomitting after feeding.

       Potential complications of NG feeding.

                 * Lung aspiration.

                 * Tube blockage

                   * Diarrhoea.

                     * Constipation.

                     * Vomitting.

                     * Hyperglycemia.

                     * Electrolyte imbalances.

        Nursing interventions for potential complications.

           * Avoid overfeeding through NG tube.

                     * Proper flushing of tube after giving food through NG tube.

                     * Stop feed if patient shows any signs of aspiration and inform

                       to the physician immediately.

                      * Preparing feed based on calorie requirement calculated by dietition

                         to avoid hyperglycemia and electrolyte imbalance.