Page 35 - Critical Care Notes

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Enteral Tube Feeding Complications—cont’d

Mechanical Complications Interventions
Tube displacement • Reposition tube.
Extubation • Insert new tube.
• Consider PEG or PEJ tube.
Stomal leak or infection • Keep area around stoma clean
and dry.
Nonmechanical Complications Interventions
Nausea, vomiting, cramps, bloating, • Withhold or decrease amount,
abdominal distention rate, and frequency of feedings.
• Change to low-fat formula.
Diarrhea • Withhold or decrease amount,
rate, and frequency of feedings.
• Change formula.
• Administer psyllium fiber
(Metamucil)
Aspiration • Hold feedings. Check residuals.
• Keep HOB elevated 30°–45°dur-
ing feedings and 1 hr after bolus
feedings.
Gastric reflux • Hold feedings. Check residuals.
• Keep HOB elevated 30°–45°.
Dumping syndrome: nausea, vomiting, • Withhold or decrease amount,
diarrhea, cramps, pallor, sweating, rate, and frequency of feedings.
↑ HR

Total Parenteral Nutrition (TPN)
TPN is an IV solution of 10%–50% dextrose in water (CHO), amino acids (pro-
tein), electrolytes, and additives (vitamins, minerals, trace elements of insulin,
vitamin K, zinc, famotidine). Fat emulsions provide fatty acids and calories.
Solutions >10% dextrose must be infused via a central line.
■ 1000 mL 5% D/W contains 50 g sugar = <200 calories
■ 1,000 mL 25% dextrose contains 250 g sugar = 1,000 calories

BASICS