The patient has just started on enteral feedings, and the patient ...

[fahad]

The patient has just started on enteral feedings, and the patient is reporting abdominal cramping. Which action will the nurse take next?
 
  a. Slow the rate of tube feeding.
  b. Instill cold formula to numb the stomach.
  c. Change the tube feeding to a high-fat formula.
  d. Consult with the health care provider about prokinetic medication.

Question 2

The nurse is concerned about pulmonary aspiration when providing the patient with an intermittent tube feeding. Which action is the priority?
 
  a. Observe the color of gastric contents.
  b. Verify tube placement before feeding.
  c. Add blue food coloring to the enteral formula.
  d. Run the formula over 12 hours to decrease overload.

[prumorgan]

Answer to Question 1

ANS: A
One possible cause of abdominal cramping is a rapid increase in rate or volume. Lowering the rate of delivery may increase tolerance. Another possible cause of abdominal cramping is the use of cold formula. The nurse should warm the formula to room temperature. High-fat formulas are also a cause of abdominal cramping. Consult with the health care provider regarding prokinetic medication for increasing gastric motility for delayed gastric emptying.

Answer to Question 2

ANS: B
A major cause of pulmonary aspiration is regurgitation of formula. The nurse needs to verify tube placement and elevate the head of the bed 30 to 45 degrees during feedings and for 2 hours afterward. While observing the color of gastric contents is a component, it is not the priority component; pH is the primary component. The addition of blue food coloring to enteral formula to assist with detection of aspirate is no longer used. Do not hang formula longer than 4 to 8 hours. Formula becomes a medium for bacterial growth after that length of time.