Nasogastric Tube Feedings

1. Definition of "nasogastric tube feeding."

1. A nasogastric tube is a tube inserted through the nose reaching to the stomach.

2. The client can receive complete nutrition without eating.

2. How to perform a tube feeding procedure.

1. Gather all equipment.

2. Wash hands.

3. Sit in an upright position.

4. Place towel over chest, and have emesis basin and tissues nearby.

5. Check position of tube.

1. Aspirate stomach contents with a 5--cc syringe.

2. Place end of tube into a glass of water to check of bubbles.

3. Using a 3-cc syringe, inject air into the tube while listening to stomach with a stethoscope to hear a whoosh of air.

6. Pour room-temperature feeding solution into bag and fill tubing to prevent air going into stomach.

7. Attach the feeding bag tube to the nasogastric tube and open clamp to allow solution to flow.

8. Drip rate may be ordered by physician if feeding is continuous. If feedings are intermittent, allow approximately twenty to thirty minutes for each feeding.

9. Assess tolerance of feeding. If any distress occurs, discontinue and notify physician.

10. After feeding flush tubing with water.

11. Remain in an upright position for at least thirty minutes after the meal.

12. Chart the time and the amount given.

3. Possible complications and of measures to prevent them.

1. Complication: Infection

1. Cleanse nose twice a day with a moistened cotton-tipped applicator, and apply a water-based jelly to prevent skin breakdown.

2. Hang only the amount of feeding solution that will infuse in four hours.

3. Wash hands well; be sure work area is clean.

2. Complications: Aspiration pneumonia

1. For intermittent feedings, check position of tube before each feeding, using the above-listed methods.

2. For continuous feedings, check position every two to eight hours.

3. Remain in an upright position at least one-half hour after feeding.

3. Complication: Clogging of the tubing.

1. After each feeding, flush with 25-100 cc's of lukewarm water.

2. Change tubing as ordered by physician.

4. Complication: Electrolyte imbalance. (Provide "Electrolyte Imbalance" handout.)

1. Check urine for glucose and acetones.

2. Draw electrolyte levels as ordered.

5. Complication: Gastrointestinal disorders (diarrhea, constipation, bowel obstruction)

1. Weigh frequently for early detection of weight loss.

2. Report any intolerance of feeding solution to physician.