1. Nutrition Tube Feedings

2. Used for residents with certain medical problems (Digestive disease, cancer) Unable to swallow 3 types of enteral feedings – Nasogastric, Gastrostomy, Jejunostomy

3. Nasogastric Inserted through nose to stomach Short term use (6 weeks or less)

4. Gastrostomy Surgically inserted through abdominal wall into stomach Long term feeding (can be removed) Liquid feedings through a pump (slow rate)

5. Jejunostomy Surgically inserted through abdomen wall into second part of the small intestines Long term feeding (pump used) Used for trouble digesting food, stomach emptying, pancreatic disease, aspirate food

6. Gastrostomy & Jejunostomy While tube feeding is running HOB is 30 to 45 degrees After feeding is complete HOB is 30 to 45 degrees for 30 to 60 minutes  A continuous pump, the HOB must be elevated at all times

7. Potential Problems 1. Nausea / Vomiting 2.Diarrhea 3.Swollen stomach 4.Constipation 5.Cramping 6.Infection (Redness, swelling, fluid) 7.Choking 8.Wet breathing 9.Skin breakdown 10.C/o dryness of mouth / discomfort

8. Responsibilities 1.Frequent oral care 2.Skin care 3.Avoid tension on the tube 4.Make sure tube is not twisted 5.Notify nurse if resident is pulling tube 6.Turn resident on side if choking 7.Report abnormal signs to nurse

9. Intravenous Feedings IV – through the vein Considered supplements (given with a meal) Short term TPN (Total parenteral nutrition) Type of IV feeding Special PICC line to administer feeding Nurse cares for TPN residents