Editing Nutrition (section)

=== Complications ===

{| class="wikitable"
! Complication !! Cause !! Nursing action
|-
| Aspiration pneumonia || Reflux of formula, flat positioning, impaired gag reflex || '''Stop the feeding immediately''', turn the patient to the side, suction, administer oxygen, assess breath sounds and oxygen saturation, and notify the provider. This is the priority complication.
|-
| Diarrhea || Rapid infusion rate, hyperosmolar formula, cold formula, sorbitol-containing or hyperosmolar medications, antibiotic-associated ''Clostridioides difficile'', low fiber || Slow the rate, check medications, obtain stool studies if infection is suspected, consider a fiber-containing formula
|-
| Constipation || Inadequate free water or fiber, immobility, opioids || Increase free water flushes, consider fiber formula, mobilize
|-
| Tube occlusion || Inadequate flushing, crushed medications, formula residue || Flush with warm water using a gentle push-pull technique with a large syringe. Never force with a small-barrel syringe, which generates high pressure and can rupture the tube.
|-
| Dehydration and hypernatremia || Insufficient free water; formula is not all water || Calculate and provide free water; monitor sodium and BUN
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| Hyperglycemia || High carbohydrate load, stress response, steroids || Monitor glucose, adjust formula or insulin
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| Nausea and high residuals || Delayed gastric emptying, rapid rate || Reduce rate, consider post-pyloric access or a prokinetic agent
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| Tube dislodgement || Traction, agitation || For a mature gastrostomy tract, cover and notify the provider promptly, since the stoma can begin to close within hours. Do not blindly reinsert unless trained and authorized.
|}