Question

An order to initiate TF was written for a patient in ICU: "Start Jevity 1.2 as tolerated. Goal rate is 50 cc/hr." The nurse should do the following:

Select one:

a. Start the TF via the NG tube at 1.2 ml/hr and check the residuals after 4 hours

b. Start the tube feeding infusion at 50 cc/hr and check the residuals after 2 hours

c. Check the bowel sounds and start TF at 10 cc/hr if +BS

d. Check the residuals before starting the tube feeding

e. none of the above

Answer 1

Answer: c)  Check the bowel sounds and start TF at 10 cc/hr if +BS.

10cc is the adequate amount to start tube feeding when the goal is 50cc/hr. Bowel sound( BS) to be checked before feeding. Hold the feeding and notify the physician if there is no bowel sound.

1.2ml/hr is too low to reach 50cc/hr . The goal is 50cc/hr, so it should not starts with rate lower than 50cc. residual amount needs to be checked every 4hours of feeding to assess the tolerance of the feed.