Which of the following nursing interventions should the nurse perform for a female client receiving enteral feedings through a gastrostomy tube?
A. Change the tube feeding solutions and tubing at least every 24 hours.
B. Maintain the head of the bed at a 15-degree elevation continuously.
C. Check the gastrostomy tube for position every 2 days.
D. Maintain the client on bed rest during the feedings.
Correct Answer: A. Change the tube feeding solutions and tubing at least every 24 hours.
Tube feeding solutions and tubing should be changed every 24 hours, or more frequently if the feeding requires it. Doing so prevents contamination and bacterial growth. The feeding bag should be changed every 24 hours. Food (formula) should not be left in the bag for more than 4 hours. So, only put 4 hours (or less) worth of food in the feeding bag at a time.
Option B: The head of the bed should be elevated 30 to 45 degrees continuously to prevent aspiration. Lying prone/supine during feeding increases the risk of aspiration and therefore where clinically possible the child should be placed in an upright position. If unable to sit up for a bolus feed or if receiving continuous feeding, the head of the bed should be elevated 30-45 degrees during feeding and for at least 30 minutes after the feed to reduce the risk of aspiration.
Option C: Checking for gastrostomy tube placement is performed before initiating the feedings and every 4 hours during continuous feedings. Correct placement of the tube should be confirmed prior to administration of an enteral feed by checking the insertion site at the abdominal wall and observing the client for abdominal pain or discomfort. If the nurse is unsure regarding the position of the gastrostomy or jejunostomy tube contact the medical team immediately.
Option D: Clients may ambulate during feedings. Tube feeding doesn’t need to keep the client from most physical activities. He can run or walk, but the client should talk to a doctor about yoga or other exercises that work the abdomen muscles. Even swimming is fine if the incision site has healed and the water is clean.
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