Administration of medication & enteral feeding

Introduction

An adequate way to deliver nutrients directly to the gastrointestinal tract is through enteral feeding. This definition applies to orogastric, nasogastric, and gastrostomy tube feeding in this recommendation. For a variety of causes, along with the following, a wide range of kids may need enteral feeding for a short or long time:

Not being able to consume enough nutrientsPoor swallowing or suckingStructural issues with the face or oesophagusAnorexia brought on by a long-term conditionVarious sorts of Eating disordersheightened nutritional needsDifferent kinds of Congenital anomaliesIllness prevention and treatment.

Enteral feeding tubes can be widely used for the purpose:
Administer bolus, continuous feeds, & intermittent feedsadministration of medicationFacilitation of free drainage & aspiration of the stomach contentsFacilitation of the venting/decompression of stomachStenting process of the oesophagus 

Goal:
This recommendation is intended to assist nurses in safely and appropriately giving feeds and drugs through a nasogastric, orogastric, or gastrostomy tube.

It should be noted very clearly that this recommendation don'taddress the management of jejunal tubes; instead, you should refer to the Jejunal Feeding Guideline for information on their maintenance.

Term definitions

Orogastric tube (OGT): A thin, soft tube that is inserted into a child's mouth, oropharynx, oesophagus, and stomach.Nasogastric tube (NGT): A small, soft tube that is inserted into a child's nose, throat, oesophagus, and stomach..A gastrostomy tube is regarded as a feeding tube that is surgically or endoscopically placed into the stomach through the abdominal wall.Gastrostomy tube with a temporary balloon device (G-Tube)]PEG, or percutaneous endoscopic gastrostomy tube, is a gastrostomy tube that is fixed in place internally.Gastric Residual Volume (GRV) - the volume of fluid aspirated from the stomach using an enteral tube to track abdominal decompression, gastric emptying, and tolerance to enteral feeding. Once removed, it can either be given back to the patient or thrown away.Trans-Anastomotic Tube (TAT tube) - Used following surgery to correct oesophageal atresia placed by surgeons in the Neonatal patient group.

Various Assessments

Orogastric Tube or Nasogastric Tube - Checking the Position 

Nurses must confirm that the tube is in the stomach before accessing an NGT or OGT for any reason. Movement, vomiting, and coughing might cause the tube to shift from its intended location. The tube's position needs to be verified:

Before every feedBefore the time of each round of medicationBefore putting anything down on the tubeIf the child has in case vomited severely.Receiving some continuous feeds for a time period of 4 hours.

The following observations should be made by nursing staff, and a stomach aspirate should be obtained to determine tube location.

Make sure the taping is solidCheck the NGT/OGT position marker and record it, then compare it to the initial data.Keep an eye out for the child's respiratory problems.

The Gastrostomy tube

Before administering an enteral feed, the tube's proper placement should be verified by feeling the child's abdomen for pain or discomfort and inspecting the insertion site at the abdominal wall. Contact the medical team right once if the nurse is unsure of where the gastrostomy or jejunostomy tube should be placed.

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