NCLEX RN Practice Question # 582

NCLEX Examination.

Practice Question # 582.

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GASTROINTESTINAL TUBE FEEDINGS

Types of tubes and anatomical placement

• Nasogastric: Nose to stomach
• Nasoduodenal-nasojejunal: Nose to duodenum or jejunum
• Gastrostomy: Stomach
• Jejunostomy: Jejunum

Types of administration

Bolus

1. A bolus resembles normalmeal feeding patterns.
2. Formula is administrated over a 30- to 60- minute period every 3 to 6 hours; the amount of formula is prescribed by the physician.

Continuous

1. Feeding is administered continually for 24 hours.
2. An infusion feeding pump regulates the flow.

Cyclical

1. Feeding is administered in the daytime or nighttime for approximately 8 to 16 hours.
2. An infusion feeding pump regulates the flow.
3. Feedings at night allow for more freedom during the day.

Administration of feedings

• Check the physician’s prescription and agency policy regarding residual amounts; usually, if the residual is less than 100 mL, feeding is administered; large-volume aspirates indicate delayed gastric emptying and place the client at risk for aspiration.
• Assess bowel sounds; hold the feeding and notify the physician if bowel sounds are absent.
• Position the client in a high Fowler’s position; if comatose, place in high-Fowler’s and on the right side.
• Assess tube placement by aspirating gastric contents and measuring the pH (should be 3.5 or lower).
• Aspirate all stomach contents (residual), measure the amount, and return the contents to the stomach to prevent electrolyte imbalances.

6. Warm the feeding to room temperature to prevent diarrhea and cramps.

• Use an infusion feeding pump for continuous or cyclic feedings.
• For bolus feeding, maintain the client in a high Fowler’s position for 30 minutes after the feeding.
• For a continuous feeding, keep the client in a semi-Fowler’s position at all times.