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In: Nursing

An 80-year-old patient with a history of aspiration is receiving nasoenteric tube feedings every 4 hours....

An 80-year-old patient with a history of aspiration is receiving nasoenteric tube feedings every 4 hours.

• Using the nursing process as a framework for care of the patient receiving nasoenteric nutrition support, explain measures used to reduce the risk of aspiration.

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Expert Solution

ANSWER :

NURSING CARE IN PATIENT RECEIVING NASOENTERIC NUTRITION :

1.Provide oral and skin care - Give mouth rinses and apply lubricants to patients lips and nostrils.

2.Verify NG tube placement -

  • Aspirating stomach contents - This indicates the proper position of tube in the stomach.Amount of residual volume reflects gastric emptying time and indicates if feeding should proceed.
  • Injecting 10 - 20 ml of air into tube -Gurgling sound usually sound that the tube is in the stomach.
  • Measuring pH of aspirated gastric secretions -Gastric contents are acidic ,pH indicator strip reflect a range of 1-4.
  • Taking an X ray or ultrasound .

3.Wear gloves - Wear gloves while starting an NG to prevent contact with patients blood and body fluids.

4.Face and eye protection -It is needed if the risk for vomiting is high for the patient.

STEPS IN MONITORING NG TUBE :

  • Confirm physicians order for NG tube, type of suction and direction for irrigation.
  • Observe drainage from NG tube- check amount ,colour ,consistency and odour.Check hematest drainage to confirm presence of blood in drainage.
  • Inspect suction apparatus every 2 hours -Check that setting is correct for the type of suction(continous or intermittent), range of suction (low ,medium and high).
  • Assess placement of NG tube.
  • Assess comfort ,mobility and respiratory status of client.
  • Assess clients abdomen for distension and auscultate for presence of bowel sounds.
  • Observe condition of clients nostrils and oral cavity.
  • Record and measure NG irrigations and drainage.

MEASURES TO PREVENT ASPIRATION :

  • Patient should be fed sitting up or at a 30 -45° semirecumbant body position.
  • They should remain in that position atleast for 1 hr after feeding is completed.
  • Iso-osmotic feeds are preferred since high osmolality feeds delay gastric emptying.
  • Intermittent feeding(200-400 ml every 4 hrs)is preferred for gastric feedings due to reservoir of stomach.
  • Gastric residual volume should be checked since there may be increased risk of aspiration if gastric contents accumulate.
  • Promotility drugs decrease the risk of aspiration.

Nightingale answered 1 year ago
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