NG Tube Feedings

■ Confirm placement before using: (1) Using 20-mL syringe, inject 20-mL bolus of air into feeding tube while auscultating abdomen. Loud gurgling indicates proper placement. DO NOT attempt this with water! (2) Use 20-mL syringe and gently aspirate gastric content. Dip litmus paper into gastric aspirate; pH of 1–3 suggests proper placement.

■ Maintenance: Flush with 30 mL of water every 4–6 hours and before and after administering tube feedings, checking for residuals, and administering medications.

■ Medication: Dilute liquid medications with 20–30 mL of water. Obtain all medications in liquid form. If liquid form is not available, check with pharmacy to see if medication can be crushed. Administer each

medication separately and flush with 5–10 mL of water between each medication. Do not mix medications with feeding formula!

■ Residuals: Check before bolus feeding, administration of medication, or every 4 hours for continuous feeding. Hold feeding if _100 mL and recheck in 1 hour. If residuals are still high after 1 hour, notify physician.

Types of Tube Feedings

■ Initial tube feedings: Advance as tolerated by 10–25 mL/hour every 8–12

hours until goal rate is reached.

■ Intermittent feedings: Infusions of 200–400 mL of enteral formulas several

times per day infused over a 30-minute period.

■ Continuous feedings: Feedings initiated over 24 hours with the use of an

infusion pump.

Checking Residuals

■ Using 60-mL syringe, withdraw from gastric feeding tube any residual formula that may remain in stomach.

■ Volume of this formula is noted, and if it is greater than predetermined amount, stomach is not emptying properly, and next feeding dose is withheld.

■ This process can indicate gastroparesis and intolerance to advancement to higher volume of formula.