Question

A 42 year old male patient in ICU, 3 days s/p MVI with head injury, currently with respiratory failure, on vent support and induced coma. Patient has active bowel sounds, and the following order is in the patient's chart:

Initiate Tube feeding: Jevity, start at 20 cc/hr, advance by 20 cc Q4h, as tolerated, until goal rate of 80cc/hr.

It's your shift. It's currently 9 AM.

Describe step by step, how you would initiate the tube feeding, what you will be looking out for, how you would be advancing the TF, etc.

Please answer it use your OWN WORDS, do not use handwriting, I have trouble to read it.

Answer 1

A feeding tube is used to provide nutrition to people .It is used for patient who cannot obtain nutrition by mouth or unable to swallow .The state in which we use a feeding tube to provide nutritional supplements is called gavage, enteral feeding or tube feeding.

Procedure for tube feeding

Wash your hands properly before tube feeding .

1) Measure the correct amount of food or supplement and warm it to the desired temperature .

2) Always ensure that tube placement by observing the mark .

3)Clamp the tube.

4) Attach a syringe to the feeding tube.

5)Pour the food and suppliments to the syringe up to mark .

6)Unclamp the tube.

The most frequent problem occours while performing tube feeding are

inadvertent removal of the tube

broken tube

plugged tube

tube leakage

dermatitis of the stoma

diarrhea .

Procedure for advancing the feeding tube

1)Inoder for the free movement the tube is pushed 3-4 cm into the abdomen

2) Remove the tube back out of the abdomen when you feel resistance.

3)plce a fixation plate or bolster at the abdomen.

4) Ensure to keep sufficient space between the skin and fixation plate so that patient can take a deep breath comfortably when sitting upright.

5)The tip of the fixation plate or bolster should be placed 1 cm from skin so it does not restrict movement or cause local ischaemia to the patient when sitting upright .