enteral feeding

Enteral feeding or medications through nasogastric, gtube, jpeg are rarely assigned during the PCS. Remember it says that even for medications, you will be assigned meds only through 2 routes... usually PO meds and IV are more common. It does say in the you could be assigned meds through a gtube but not ng tube.

Now lets talk about when you would assess and how would you assess.

For G-tubes and J-peg tubes since their placement has already been verified with an x-ray you wouldn't have to check placement, in addition to some of the "weighted" tubes.

Lets say Pts on continuous feeding... it says on the Kardex hold feeding if >100 mLs.
Actually at most hospitals, the rule of thumb/protocol usually is to hold feedings if >2X the hourly rate of feeding. So if the feeding is going at 70mL/hr, you would hold the feeding if residual is >140ml and you come back a little later and check again, to ensure gastric emptying before restarting the feeding again. (Just a side note... also don't forget to check dates on the feeding bag and the tubing... usually to be discarded after 24 hrs)

This is a little confusing... cause in the 21st Ed study guide, verifying NG tube placement is even more vague than any other previous editions. Here is what I suggest.. Since only NG needs to be verified, you will ask the assigned nurse in a hospital policy type of way.. Per hospital policy, what is the accepted method of verifying NG tube placement.

Historically, it has been instilling air and auscultating, then pulling residual (sometimes even checking the pH). But with the advent of the newer equipment, there is a constant shift in nursing procedures. For example, these days instead of the NG tubes, you insert the NG "Corpak" a thin flimsy tube that initially is inserted using a metal stylet. You send the patient for X-ray, then wait for the Dr's call to insert it further in a couple of inches, or that it is coiled, and pull it back some. There is no reason to be anxious. For things that are not usually assigned, you ask the right questions... but the CEs usually are more than helpful, given that you are missing a beat on some of the other required critical elements in other assigned areas of care.