Editing Nutrition – RN Flashcards (section)

== Enteral Nutrition ==

;What is the gold standard for verifying initial placement of a blindly inserted feeding tube?
:Radiographic confirmation before the first use. Auscultating an injected air bolus is unreliable and no longer recommended. Ongoing checks use the external tube marking, measured tube length, and gastric aspirate.

;What is the most important aspiration precaution during enteral feeding?
:Keeping the head of the bed elevated 30 to 45 degrees during the feeding and for at least 30 to 60 minutes afterward.

;What is the nursing priority if a tube-fed client coughs, becomes dyspneic, and desaturates?
:Stop the feeding immediately, turn the client to the side, suction, apply oxygen, assess breath sounds and saturation, and notify the provider. A chest radiograph follows.

;How should feeding tubes be flushed, and what should never be used?
:Water, roughly 30 mL, before and after each feeding and each medication, between medications, every 4 hours during continuous feeding, and after any interruption. Cranberry juice and cola are ineffective and worsen clogging.

;Which medication formulations must never be crushed for tube administration?
:Enteric-coated, sustained-release, and extended-release products, because crushing destroys the release mechanism and delivers the full dose at once. Use a liquid or an immediate-release alternative instead.

;What causes diarrhea in a tube-fed client, and how is it approached?
:Rapid infusion rate, hyperosmolar formula, cold formula, sorbitol-containing or hyperosmolar liquid medications, antibiotic-associated ''Clostridioides difficile'', and low-fiber formula. Slow the rate, warm the formula to room temperature, review medications, evaluate for infection, and consider a fiber-containing formula.

;When is post-pyloric (nasoduodenal or nasojejunal) feeding preferred?
:With gastroparesis, high aspiration risk, persistent high gastric residuals, and pancreatitis. Post-pyloric feeding must be continuous, because the small bowel has no reservoir capacity for boluses.