A patient is receiving intermittent enteral tube feedings. When ...

[schs14]

A patient is receiving intermittent enteral tube feedings. When introducing a feeding to this patient, what is the first thing the nurse needs to do?
 
  a. Place the patient in a supine position.
  b. Irrigate the tube with normal saline.
  c. Check to see that the tube is in the proper position.
  d. Introduce a small amount of fluid into the tube before the tube feeding.

Question 2

A patient with head trauma is scheduled for a gastrostomy tube to be inserted. The spouse asks the nurse why an intravenous (IV) cannot be used. What is the nurse's best response?
 
  a. The gastrostomy tube will allow us to give medications as well as feedings.
  b. Research has shown that a gastrostomy tube is safer for patients and maintains function of the gut.
  c. It will be more expensive in the long run to use a gastrostomy tube than an IV.
  d. The gastrostomy placement is noninvasive, and the patient will be more content being fed through the stomach.

[bhavsar]

Answer to Question 1

C
The first step is verify tube placement; feedings instilled into a misplaced tube can cause serious injury or death. You will place the patient in Fowler's or high-Fowler's position, not supine, before starting the feeding. After checking for residual, flush the feeding tube with 30 mL of water, not normal saline. Fluid is not inserted until placement is verified.

Answer to Question 2

B
Research has demonstrated a beneficial effect of enteral nutrition over parenteral routes in patients with a functional GI tract. Therefore enteral feeding is preferred over parenteral nutrition (intravenous nutrition) because it improves use of nutrients, is generally safer for patients, maintains structure and function of the gut, decreases the risk for infection and sepsis, and is less expensive, not more expensive. Medications can also be given through an IV, so this does not answer the spouse's question. The gastrostomy placement is invasive as the tube is inserted directly into the stomach.

[schs14]

Excellent

[bulacsom]

TYSM