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Lesson 42. Gastrostomy Tube Feeding

1-42. GASTROSTOMY TUBE FEEDING

A gastrostomy tube feeding should be treated as a normal meal. The procedure must never be rushed, and the atmosphere should be pleasant and relaxing for the patient. The prescribed feeding may be a commercially prepared formula or a special preparation from the hospital food service. The procedure for administration of a gastrostomy tube feeding is as follows.

a. Review the patient's clinical record to verify physician's order for the amount and type of tube feeding.

b. Wash your hands.

c. Collect the necessary supplies and equipment.

(1) Feeding solution, as prescribed.

(2) Large bulb syringe or catheter tip 50cc syringes.

(3) Tap water.

(4) Graduated container for measuring.

d. Prepare the tube feeding, as ordered.

(1) For 1/4, 1/2, or 3/4 strength feeding, mix the solution with the appropriate amount of water to obtain the desired strength.

(2) Always check the label of a commercially prepared formula for expiration date.

(3) When mixing a feeding formula, label with date, time, and initials.

(4) Warm solution to room temperature to prevent cramps and gas formation.

e. Approach and identify the patient and explain procedure.

f. Provide for patient privacy.

g. Place patient in semi-fowler's position in bed to promote digestion.

h. Fold top linen down to expose gastrostomy tube and protect area with towel.

i. Attach the syringe to the clamped gastrostomy tube.

(1) Remove plunger if using a 50cc catheter tip syringe.

(2) Remove bulb from bulb syringe.

j. Check patency of the tube by pouring a small amount of water from the graduated container into the syringe.

(1) Remove clamp.

(2) If water flows freely, the tube is patent.

(3) If water does not flow freely, notify the professional nurse.

k. Pour feeding solution into the syringe.

(1) As solution flows into the stomach, tilt the syringe to allow air bubbles to escape.

(2) Add more solution to the syringe when about one quarter of it remains.

(3) Increase or decrease the flow rate by raising or lowering the syringe.

(4) Depending upon the solution's consistency, and the amount, feeding may take 10 to 20 minutes.

l. After administering the ordered amount of feeding solution, flush the tube with 30 ml of water to clear the feeding solution residue.

m. Clamp or plug the tube to prevent leakage.

n. Instruct patient to remain in a sitting position for 30 minutes to enhance normal digestive process.

o. Record feeding on intake and output record. Record procedure and the patient's tolerance in the nursing notes.

p. Check back with the patient. He should not feel overly full or nauseated. Report these symptoms to the professional nurse at once. Gastric distress may require adjustment of feeding schedule.

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