enteral tube feeding

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1. the taking of food.
2. the giving of food.
3. in the nursing interventions classification, a nursing intervention defined as providing nutritional intake for a patient who is unable to feed self.
artificial feeding feeding of a baby with food other than mother's milk.
bottle feeding in the nursing interventions classification, a nursing intervention defined as preparation and administration of fluids to an infant via a bottle.
breast feeding breastfeeding.
enteral tube feeding in the nursing interventions classification, a nursing intervention defined as delivering nutrients and water through a gastrointestinal tube.
forced feeding administration of food by force to those who cannot or will not receive it.
intravenous feeding administration of nutrient fluids through a vein; see also intravenous infusion and parenteral nutrition.
feeding procedures in the omaha system, any method of giving food or fluid, including breast, formula, intravenous, or tube.
supplemental feeding a planned additional food or nutrient that is added to the usual diet, often as a powder, formula, or tablet.
tube feeding see tube feeding.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

enteral tube feeding

A means of providing nutrition for a patient unable to consume food normally. The patient may have difficulty with chewing or swallowing or an oral, pharyngeal, or esophageal deformity. The patient is fed an appropriate nutritional formula through a tube passed into the stomach or duodenum from the nasal passage (nasogastric or nasoduodenal tube) or by a gastrostomy tube, gastrostomy button, or gastrojejunostomy tube. Synonym: total enteral nutrition

Patient care

Short-term feeding (less than 4 weeks’ duration) can usually be managed with a nasogastric tube. Longer-term feeding requires a surgically implanted feeding tube. The choice of tube is determined by a number of factors, including the expected duration of feeding, the condition necessitating the feeding, concomitant conditions, and clinician preference. The percutaneous endoscopic gastrostomy tube (PEG) is the most common method for tube insertion. The tube is placed using direct endoscopic visualization through an abdominal incision, and anchored in place with an outer flange and an inner bump or balloon. It enters through the abdominal wall into the stomach. The gastrojejunostomy tube is a smaller-bore tube advanced through the stomach into the jejunum tube. It delivers contents into the jejunum and is used for patients with recurrent aspiration, upper gastrointestinal obstruction or fistula, gastroparesis, and gastroesophogeal reflux. It cannot be used in patients with small bowel disease because it can cause enterocutaneous fistulae. The smaller bore increases the probability of clogging, which requires more frequent tube flushing and replacement. The gastrostomy button prevents some of the chronic complications of gastrostomy tubes (clogging, leaking, and skin irritation). The button is skin level and out of sight when the patient is clothed. It usually replaces a gastrostomy tube 4 weeks after the initial PEG to ensure development of a mature tract. Tube placement is confirmed by X-ray. Health care professionals need to assess the patient (and teach the patient and other care providers how to assess) for leakage (recognizing that high abdominal pressure, as occurs with sneezing or coughing, often causes some normal leakage), skin irritation, infection, and formation of granulation tissue. Nutrition and hydration status and signs and symptoms of aspiration, pneumonia, or GI complications (such as bleeding or peritonitis) also need to be assessed. The professional care provider should use the time with the patient while flushing and assessing tube concerns to teach the patient and family caregivers how to care for the tube and to offer support as the patient and significant others adjust to body image changes and the loss of eating pleasures. Flushing enteral tubes to keep them free from build-up is essential, because unclogging a tube wastes time, effort, and resources. The best method of tube flushing is a matter of active research; local protocols apply. Tubes that cannot be unclogged must be replaced.

There are four types of nutrient formulas: intact nutrient, hydrolyzed nutrient, elemental (defined), and modular. Intact nutrient formulas are called standard because the nutrients are whole and therefore are appropriate for use whenever normal digestion takes place. They usually provide 1 kcal/ml and can be used orally. In hydrolyzed nutrient formulas the nutrients are predigested and are suitable for use whenever malabsorption is present or when the jejunum is the feeding site. These formulas are not appropriate for oral use because of their taste. They are more expensive than intact nutrient formulas. In elemental (defined) formulas the nutrients are in the simplest, most basic, form and are rapidly absorbed from the gut. These formulas are not appropriate for oral use. This type of formula is the most expensive. Formulas designed for specific diseases are available. In modular formulas, commercially produced nutritional products may be used as supplements to standard formulas. For example, the addition of a protein module would convert a standard formula to a high-protein formula.

There are four kinds of delivery: bolus, intermittent infusion, cyclic infusion, and continuous drip. In bolus administration the formula is delivered in four to six daily feedings by a large syringe attached to the feeding tube in the stomach. This type of delivery is the least well tolerated. In intermittent infusion the formula is delivered four to six times daily over 30 to 60 minutes using a pump or gravity flow. In cyclic infusion an infusion pump delivers the nutrient solution for specified hours of the day and is turned off during other hours. In continuous drip an infusion pump delivers nutrition all day long.

See also: feeding
Medical Dictionary, © 2009 Farlex and Partners
References in periodicals archive ?
Cooperation and appropriate nursing care were more likely to occur when nurses had knowledge of enteral tube feedings and patient care, an explicit understanding of their nursing responsibilities in caring for the patient, and commitment to patient-related care.
Outcomes associated with enteral tube feedings in a medical intensive care unit.
[20.] Sneed RC, Morgan WT: Interference of oral phenytoin absorption by enteral tube feedings. Arah Phys Med Rehabil 1988; 69(9):682-684.
Factors associated with nosocomial diarrhea in patients with enteral tube feeding. Nutrition Hospitalaria, 23(5), 500-504.
An expansion on initial enteral tube feeding verification methods is provided.
Clinical use of gastric residual volumes as a monitor for patients on enteral tube feeding. Journal of Parenteral and Enteral Nutrition, 26(Suppl.
A rule of thumb is to provide 30 to 35 ml of fluid per kilo gram of body weight per day, or 1 ml of fluid per calorie fed for patients receiving enteral tube feeding (Campbell & Hall, 1997).
Infustion protocol improves delivery of enteral tube feeding in the critical care unit.
Table 3 provides a list of indications and contraindications for enteral tube feeding.
Enteral tube feeding products come in a variety of forms and sizes, with at least 90 different types commercially available.
Answers ranged from 100 to 300 millimeters and included a physician who was unsure.The literature was reviewed and an evidence-based guideline for the management of enteral tube feedings was discovered from the American Society of Parenteral and Enteral Nutrition (ASPEN) (Bankhead et al., 2009).