feeding

2.  An artifical, surgically made opening
connecting the inside of the stomach to the
abdominal wall through which a tube is placed.
In gastrostomy a part of the stomach is brought
to the abdominal wall and an opening is made
through the abdominal wall. A tube is inserted
into it through which feeding can be given.

4.  Syringe feeding : in this method, with the help
of the syringe that may be of 50cc is used to
give the feed according to the physician’s order

5.  To maintain nutritional status of a patient
whose upper gastrointestinal tract is bypassed.

6.  Impaired swallowing and decreased level of
consciousness
 Tumours and fistulas on the upper alimentary
tract
 In case of post-operations of the upper
alimentary tract, when the tract makes it
impossible for food to reach the stomach by the
normal route

7.  Disposable gavage bag and tubing
 60 ml syringe
 Stethoscope
 Feed
 IV stand
 Administration set

8.  Identify the patient’s
need
 Assess patient for
allergies
 Auscultate for bowel
sounds before feeding
 The type and timing of
feed needs to be
planned
 Prevents patient from
developing localized or
systemic allergic
responses
 Bowel sounds indicate
presence of peristalsis
and ability of
gastrointestinal tract to
digest nutrients

9.  Verify physician’s
order for formula, rate
and frequency
 Assess gastrostomy
site for breakdown,
irritation or drainage
 Wash hands
 Reduces errors in the
feeding process
 Infection, pressure
from gastrostomy
tube or drainage of
gastric secretions can
cause skin breakdown
 Well-informed client
is more cooperative
and feels more at ease

10.  Prepare feeding
container to administer
formula continuously:
 Have tube feeding at
room temperature
 Connect tubing to
container as needed or
prepare ready to hang
container
 Reduces transmission of
microrganisms
 Cold formula may
cause gastric cramping
and discomfort because
liquid is not warmed by
mouth

11.  Elevate head of bed at
30-40
 Apply gloves and verify
tube placement
 Check placement of
gastric tube. Aspirate
gastric secretions and
check gastric residual
contents
 Elevating client’s head
helps prevent chance of
aspiration
 Presence of gastric
contents indicates that
end of tube is in
stomach. Gastric
residual contents
determines if gastric
emptying is delayed

12.  Initiate feeding:
 Bolus or intermittent feeding
- Pinch proximal end of
gastrostomy tube
- Attach syringe to end of
tube and elevate to 18
inches above the patient’s
abdomen
- Fill syringe with formula.
Allow syringe to empty
gradually and refill it until
prescribed amount has
been delivered to the
patient
Prevents air from entering the
patient’s stomach
Gradual emptying of tube
feeding by gravity from a
syringe or gavage bar
reduces the risk of
diarrhoea induced by
bolus tube feedings

13. - If gavage bag is used,
attach bag to the end
of the feeding tube
and raise, bag 18
inches above patient’s
abdomen. Fill bag
with prescribed
amount of feed, allow
bag to empty
gradually over 30
minutes

14.  Continuous drip
method:
- Hang gavage bag to
IV pole
- Connect end of bag to
the proximal end of
the gastrostomy tube
- Connect infusion
pump and set rate.
 Continuous feeding
method is designed to
deliver a prescribed
hourly feeding. This
method reduces the
risk of diarrhoea.
Patient who receives
continuous drip
feedings should have
residual gastric
contents checked
every 4 hours

15.  When tube feedings are
not being administered,
clamp the proximal end
of the feeding tube
 Administer water via
feeding tube as ordered.
 Rinse bag and tubing
with warm water after
bolus feedings
 Prevent air from
entering the stomach
between feedings.
 Provides patient with
source of water to help
maintain fluid and
electrolyte balance

16.  Change gastrostomy
exit site dressing as
needed. Inspect site
every shift. Clean
ostomy site daily with
warm water. A small
gauze dressing may
be applied to exit site.
 Dispose off supplies
and wash hands
 Leakage of gastric
drainage may cause
irritation
 Reduces transmission
of microorganisms

17.  Evaluate patient
tolerance to tube
feeding.
 Monitor blood
glucose every 6 hours
 Monitor intake output
every shift
 Weigh patient daily
 Tolerance to tube
feeding is evaluated
by checking the
amount of aspirate
every 4 hours
 Indicates fluid balance
 Indicates nutritional
status

18.  Record amount and
type of feeding,
patency of tube and
any untoward effects
 Documents patient’s
reaction to therapy
and identifies
presence of any
adverse reactions

19.  Skin surrounding gastrostomy site breakdowns
 Aspiration of formula
 Client develops diarrhoea.