"case report" "patient" "tube feeding"

How do you diagnose a misplacement of a feeding tube?

If the tip of the tube is below the lower edge of the x-ray, get an abdominal flat plate. If confirmed, begin tube feedings when appropriate and observe for findings indicative of feeding tube misplacement 17 (see text). If not confirmed, reposition and repeat the confirmation process. Check (and document) the gastric pH.

How do you manage misplacement of a nasoenteric feeding tube?

In patients at high risk for misplacement of nasoenteric feeding tubes (see text), at least once daily, if possible, stop feedings until the upper small bowel is empty, then check tube feeding residuals and the pH of the aspirate.

Can PA-PSRs verify the location of nasogastric and nasoenteric feeding tubes?

This article will review reports to PA-PSRS indicating problems from misplacement of nasogastric and nasoenteric feeding tubes, review the literature on proper verification of the location of these feeding tubes, and propose algorithms for confirming the location of these tubes, based on the literature review.

What is the most common problem in tube feeding?

Diarrhea. The most common reported complication of tube feeding is diarrhea, defined as stool weight > 200 mL per 24 hours.

What do you document when administering a tube feeding?

Document the drug and amount given, the date and time, the patient's response, and your assessment of the insertion site. Document all liquids administered, including flushes, on the patient's intake and output record.

What is a major complication of feeding tubes?

The most frequent tube-related complications included inadvertent removal of the tube (broken tube, plugged tube; 45.1%), tube leakage (6.4%), dermatitis of the stoma (6.4%), and diarrhea (6.4%).

What is the most common complication associated with enteral feeding?

Complications of enteral feeding. Patients with feeding tubes are at risk for such complications as aspiration, tube malpositioning or dislodgment, refeeding syndrome, medication-related complications, fluid imbalance, insertion-site infection, and agitation.

Which action would the nurse implement when feeding a patient who is prescribed aspiration precautions?

The nurse should elevate the head of the bed to a 90-degree angle prior to feedings for any patient who is prescribed aspiration precautions.

How do you document an NG tube?

Document the details of the procedure in the patient's notes:Your personal details including your name, job role and GMC number.The date and time the procedure was performed.Confirmation that verbal consent was obtained.The indication for NG tube insertion.The insertion length of the NG tube.More items...•

What are three types of tube feeding complications?

Possible complications associated a feeding tube include:Constipation.Dehydration.Diarrhea.Skin Issues (around the site of your tube)Unintentional tears in your intestines (perforation)Infection in your abdomen (peritonitis)More items...

What are 3 complications of caring for the person with a nasogastric tube?

common complications include sinusitis, sore throat and epistaxis. more serious complications include luminal perforation, pulmonary injury, aspiration, and intracranial placement.

What are the 5 signs of feeding tube intolerance?

One of the early and more difficult issues that parents face with tube feeding is feed intolerance. Feed intolerance may present as vomiting, diarrhea, constipation, hives or rashes, retching, frequent burping, gas bloating, or abdominal pain.

What potential adverse effects can occur with enteral feeds?

Patients receiving enteral nutrition show several kinds of complications such as diarrhoea, vomiting, constipation, lung aspiration, tube dislodgement, tube clogging, hyperglycaemia and electrolytic alterations.

How do you prevent aspiration in tube feeding?

Follow these guidelines to prevent aspiration if you're tube feeding:Sit up straight when tube feeding, if you can.If you're getting your tube feeding in bed, use a wedge pillow to lift yourself up. ... Stay in an upright position (at least 45 degrees) for at least 1 hour after you finish your tube feeding (see Figure 1).More items...

What are the complications of NGT?

Electrolyte imbalance ( p < 0.001) and hyper- and hypoglycaemia ( p = 0.001) were significant complications found in the NGT patients. No significant differences were found between two groups for tube feeding syndrome and vitamin and trace element deficiency.

Is NGT more complicated than peg feeding?

Overall, patients who received NGT feeding experienced more complications than those who had PEG feeding. The choice for NGT or PEG feeding may be influenced by patient related factors as well as the presence of caregivers, which need to be considered in the improvement of enteral nutrition services in the local context.

How many patients have a feeding tube malposition?

A University of Pittsburgh retrospective study of 4,190 radiographic reports identified 87 patients with a feeding tube intrabronchial malposition. Thirty-two percent of these patients experienced multiple misplacements. Each occurrence of feeding tube misplacement increased the risk for future misplacement. 23

What is the pH of a feeding tube aspirate?

In a large study of 1,284 aspirates from feeding tubes, all samples from the lungs had a pH greater than or equal to 6. 11 If the pH of the feeding tube aspirate is greater than or equal to 6, the tube may be inadvertently located in the respiratory tract. 11,17.

How often should I stop feeding my nasoenteric tube?

In patients at high risk for misplacement of nasoenteric feeding tubes (see text), at least once daily , if possible, stop feedings until the upper small bowel is empty, then check tube feeding residuals and the pH of the aspirate.

Why is fluoroscopy used for feeding tubes?

Because fluoroscopy produces clinically significant radiation exposure, this technique is used for feeding tube placement only as a last resort. 16. pH Testing. Another reliable method for ongoing tube placement verification is determining the pH of the fluid aspirated from feeding tubes.

Why do I see bubbles when I put my feeding tube in water?

This method involves observing bubbles when the end of the feeding tube is placed under water; the appearance of bubbles is thought to indicate that the feeding tube is misplaced in the respiratory tract.

Where is the tube in the chest?

The tube follows a straight course down the midline of the chest to a point below the diaphragm. The tip of the tube is below the diaphragm. The tube is not coiled anywhere in the chest. The tube does not follow the path of a bronchus. 15.

Where is the feeding tube in the chest?

A review of the x-ray showed that the feeding tube was in the main bronchus. The tube follows a straight course down the midline of the chest to a point below the diaphragm. The tip of the tube is below the diaphragm. The tube is not coiled anywhere in the chest.