SKILL LABORATORY
ADMINISTERING A TUBE FEEDING
NAME: _______________________________ YEAR & SEC.:_____________________
PROCEDURE RATIONALE
A. ASSESSMENT
1. Assess for any clinical signs of identify any deficiencies, excesses or
dehydration or malnutrition. problems with delivery
2. Assess for allergies to any food in Assess if the patient is lactose intolerant,
the feeding. check the feeding formula. Notify if the
doctor if any incompatibilities exist.
3. Assess for the presence of bowel Reduced (hypoactive) bowel sounds
sounds. include a reduction in the loudness, tone, or
regularity of the sounds. They are a sign
that intestinal activity has slowed which
indicate risk of vomiting
4. Assess for any problems that To Notify the doctor if there is any
suggest lack of tolerance of incompatibilities exist. So that there would
previous feedings. be a changes for the next feeding
B. PLANNING
1. Determine the type of feeding To ensure that you are using the most
appropriate type of feeding that is
prescribed by the physician.
2. Determine the amount of feeding To ensure that the patient is receiving the
desired amount of enteral nutrition.
3. Determine the frequency of To prevent feed intolerance.
feedings and tolerance of previous
feedings.
C. IMPLEMENTATION
1. Introduce self and verify the Explain the person what you are going to
client’s identity using the agency do, why it is necessary and how he or she
protocol. can cooperate.
2. Explain to the patient the procedure To ensure that the patient understands all
and describe each item. of the ramifications of what is happening
3. Wash hand and observe other To prevent spread of microorganism or any
infection control procedures contamination
4. Provide privacy
5. Assist the client to a Fowler’s -It is often easier to swallow in this
position (at least 30 degrees position and gravity helps the passage of
elevation) in bed or a sitting the tube.
position in a chair. -These positions enhance the gravitational
flow of the solution and prevent aspiration
of fluid into the lungs.
6. Assess for the tube placement. -To prevent spread of microorganism or
Apply clean gloves any contamination
Attach the syringe to the - To minimize the risk of aspiration
open end of the tube and - To evaluate absorption of the last feeding
aspirate.
7. Assess for residual feeding
contents.
If tube is placed in the stomach, This is done to evaluate absorption of the
aspirate all contents and measure last feeding; whether undigested formula
the amount before administering from a previous feedings remains, if the
the feeding. tube is in the small intestine, residual
contents cannot be aspirated.
8. Reinstill the gastric contents into Removal of the contents could disturb the
the stomach (if this is the agency’s client’s electrolyte balance.
policy or primary care provider’s
order)
9. Administer the feeding. -An excessively cold feeding may cause
Check the expiration date of the top of the feeding
the feeding prior -this minimizes the risk of contaminants
Warm the feeding to room entering the feeding syringe or feeding bag.
temperature.
When an open system is
used, clean the top of the
feeding container with
alcohol before opening it.
10. Syringe (Open System)
A. Remove the plunger from the -Pinching or clamping the tube prevents
syringe and connect the syringed to excess air from entering the stomach and
a pinched or clamped nasogastric avoids causing distention.
tube.
B. Add the feeding to the syringe
barrel.
C. Permit the feeding to flow -Quickly administered feedings can cause
slowly at the prescribed rate. flatus, cramps and/or vomiting.
D. Raise or lower the syringe to
adjust the flow as needed.
E. Pinch of clamp the tubing to stop -Pinching or clamping the tube prevents
the flow for a minute if the client excess air from entering the stomach and
experiences discomfort. avoids causing distention.
11. Instill 50 to 100 ml of water -Water flushes the lumen of the tube,
through the feeding tube or preventing future blockage by sticky
medication port. formula.
12. Be sure to add he water before the -Adding the water before the syringe or
feeding solution has drained from tubing is empty prevents the instillation of
the neck of a syringe or from the air into the stomach or intestine and thus
tubing of an administration set. prevents unecessary distention.
13. Clamp the feeding tube. -Clamping prevents leakage and air from
entering the tube.
14. Ensure client comfort and safety -This minimizes pulling of the tube, thus
preventing discomfort and distention.
15. Ask the cline to remain sitting -These positions facilitate digestion and
upright in Fowler’s position or in a movement of the feeding from the stomach
slightly elevated right lateral along the alimentary tract and prevent the
position for at least 30 minutes. potential aspiration of the feeding into the
lungs.
16. Document all relevant information.
Document feeding, -This determines adequate absorption and
including amount and kinds the client’s tolerance of feeding.
of fluids administered.
Record the volume of
feeding and water
administered on the client’s
intake and output record.
17. Monitor the client for possible -Carefully assesses person’s receiving tube
problems. feedings for problems. To prevent
dehydration, give the client supplemental
water in addition to prescribed tube feeding
as ordered.
