A Ward Class on:

Nasogastric Tube Feeding

Submitted to: Ms. AmorilleTorejas, RN\ Submitted by: Pagara, Rollen Keven Pelino, Miguel Salubre, Juses Corvera, Rejah Igen Daaca, Marianne Camille Diocampo, Nikki Estrella, Michelle Lauren Eugenio, Jenica Rae Gacus, Frans Marie Necessario, Charisma Petallo, Ruby Plaza, Karen Wayne Remoroza, Noelagin Saplot, Jaya Mae Tamayo, Pia Coleen BSN 2 NE

I.

DEFINITION

Nasogastric tube feeding refers to the process of administering food through the nasogastric tube.

II.

PURPOSE

To deliver tube feedings to patients who are unable to eat. o o o o Premature babies Patients in coma Patients who have had neck or facial surgery Patients on mechanical ventilation.

III.

PRECAUTIONS

Always check tube positioning before giving feedings. If the tube is out of place, the patient may aspirate the feeding solution into the lungs. Keep the patient in an upright or semi-upright position when delivering a tube feeding to enhance peristalsis and avoid regurgitation of the feeding. Check patients who are receiving continuous feedings via a pump or gravity hourly or according to the medical 2|Page

settings policy, to assure that the tube is in position, the formula is flowing at the correct rate and the patient is comfortable with no signs of distention or distress. Cap or clamp off the NGT when not in use to prevent backflow of stomach contents or accumulation of air in the stomach. If the amount of gastric aspirate is large prior to a bolus or intermittent feeding, notify the physician and follow the protocol of the medical setting for reinstilling the gastric aspirate. The feeding size may need to be decreased if the patient is not digesting it. NGT placement is meant to be a short-term solution for feeding problems. Patients that require a long term tube feeding cause should nasal have surgical sinusitis, placement esophagitis, of a gastrostomy tube or button. Long-term NGT usage can erosion, gastric ulceration, esophageal-tracheal fistula formation, oral infections and respiratory infections.

IV.

COMPLICATIONS

Obstruction of the tube Perforation of the tube Tube migration out of correct position Regurgitation and aspiration of the feeding Diarrhea Nausea and vomiting

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 Abdominal distention, cramping and discomfort from too much feeding or a rate of feeding that is too rapid Aspiration of the stomach contents leading to asphyxia, abscess formation or aspiration pneumonia Trauma injury including perforation of the nasal,

pharyngeal, esophageal or gastric tissue Pulmonary tube Nosebleeds Secondary infection in the sinus, throat, esophagus or stomach Development of a tracheal-esophageal fistula Erosion and/or necrosis of nasal, pharyngeal, hemorrhage, empyema, pneumothorax,

pleural effusion or pneumonitits from a malpositioned

esophageal or gastric tissue

V.

KEY TERMS

Empyema - a collection of pus in the lung cavity Fistula - a passageway or connecting duct that is abnormal and connects body cavities or tissues that should not be connected develop as the result of injury, disease or congenital deformity Gastrostomy button - a soft plastic apparatus with a button closure that is surgically inserted and sutured onto the surface of the abdomen placed in a surgical opening that leads from the stomach to the surface of the abdomen and is used for long term tube feedings in patients who cannot eat to prevent malnutrition

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 Gastrostomy tube - a soft plastic tube that is inserted and sutured into a surgical opening that leads from the stomach to the surface of the abdomen used for long term tube feedings in patients who cannot eat to prevent malnutrition Peristalsis - muscular contractions of the gastrointestinal tract that move food, fluids and refuse in a wave-like motion through the system Reflux - a backward flow of food or fluid from the stomach into the esophagus Regurgitation a vigorous reversed flow of the stomach contents up the esophagus and out of the mouth

VI.

PROCEDURE 1. Review the physician's order and select the appropriate type and amount of feeding.

2. Formulas that have been refrigerated should be allowed to warm up to room temperature before administering them.

3. Shake prepared formulas before administering them. 5|Page

4. Place the head of the bed 30-45 degrees during tube feedings and for 30-60 minutes after intermittent tube feedings if the patient can tolerate this position.

5. Remove the barrel from the syringe.

6. Open the end of the NG tube

7. Kink the tube to prevent air from entering the tube.

8. Connect tube to the end of the syringe.

9. Place the stethoscope over the patient's stomach and quickly inject the bolus of air into the stomach. A whooshing sound should be audible through the stethoscope over the stomach if the tube is in the stomach. If the tube is in the esophagus or trachea, the air sounds will be absent or muffled.

10. Pour the feeding into the wide end of the syringe and hold or secure the syringe to the bed or an IV pole just above the patient's head so that it will flow in slowly by gravity over 15-30 minutes.

11. If more feeding is needed than can be held in the syringe, watch the syringe and refill the syringe until the feeding is complete.

12. When the feeding is complete, rinse the tube with 30 cc of water.

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13. Kink the tube to prevent air from entering the tube. 14. Disconnect and recap the end of the NG tube. 15. Rinse the syringe according to the medical setting's policy.

VII.

RESULTS The use of a nasogastric tube for feedings can effectively prevent malnutrition in

the patient who is unable to eat. A nasogastric tube is also an effective temporary measure for decompression and removal of stomach contents and free air in a variety of gastrointestinal illnesses, major trauma, or surgery.

VIII.

HEALTH CARE TEAM ROLES Tube feedings are usually administered by a licensed nurse in the medical

setting. Non-licensed personnel may receive special training to start, stop or check tube feedings under the direction of a licensed nurse in some medical settings. Patients and patients' families may be taught by a licensed nurse to administer tube feedings in the home. Patients receiving tube feedings in the home should be monitored by visiting nurses or undergo frequent medical check-ups to assess the their responses to the feedings and the their ongoing nutritional needs.

LEGEND: (hahaha!) btw, maoh ni atong human ug visual aids friends, Noela Ruby Chari Pia

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