Tube Feeding folklore
Posted by Sean on January 26, 2012
So my classmates and I were in class yesterday. The lecture topic was Nutrition for the Acute and Critically Ill patient. We as future nurse practitioners need to understand nutritional needs as well as calculate those needs on a per patient basis. That’s not what I’m blogging about though.
My classmates and I were curious. How many nurses out there have ‘initiated’ or managed a patient on tube feeds… and they DID NOT have some sort of diarrhea??
I think most nurses think :
tube feeds = diarrhea
Whaddya think?
Courtney said
I work in Paeds so tube feeds are very common. We often nurse initiate inserting an NG and commencing NG feeds.
Nicole, BSN, RN (@moonischasingme) said
It definitely happens to all of our patients. Our physicians implement feeds pretty early on via small bowel feeding tubes, and it’s just expected that there will be loose stools, but it’s never discussed to the point of not initiating nutrition! If it gets really bad, we usually put in a dignacare.
Sean said
That’s a great point, even with the frustrating result of diarrhea… we have to provide nutrition and keep their gut active. It’s definitely a challenge to say the very least.
Nicole, BSN, RN (@moonischasingme) said
I think it works okay while in the ICU because as nurses, we’re usually in that patient’s room pretty much all the time. However, when they move to the floors, I have to wonder how much longer they will be sitting/laying in their own stool because the nurses are much busier.
Sean said
Hopefully there either off the TF, or maybe transitioning. Tough either way.
princess said
ALLL the time! It totally sucks. Ive seen nurses that even may put them on hold if there pt is having diarrhea b/c it creates all kinds of problems, = bed sores, having to turn pts and changing the bed 100x with pts that are so ill they really dont need to be roughed around 50x and aspiration is a huge thing. They gotta come up with something better. They do give some pts a supplement through the tube that is supposed to bulk it up, but it doesnt work!!! Ive been doing this for 15 yrs and im in ICU. Its hard,lol.
Sean said
Besides the obvious secondary complications (skin care), I’m learning that the diarrhea is not a contraindication. Things that make you go hmm..
Dina said
Make sure your patients are getting probiotics…it is so frequently overlooked! Florastor is a great one…it dissolves nicely in warm water making it pass through those tiny FMTs nicely! And we institute rectal tubes for persistent diarrhea. We use the Dignicare brand which seems to work well.
Sean said
I never thought of that… thanks!
princess said
we have 2 options, you can use a fecal management system which is invasive, you can put it in at bedside but it can only stay in for a month , and the second is the regular rectal bag- which you dont need an order for. gotta make sure that the stool is liquid enough or it wont go through the tubing and the bag will blow off, not pretty!!!