Feeding Tube Management

Care Plan for Feeding Tube Management

Category / Primary Body System:

Gastrointestinal System / Nutritional Support

Problem:

Resident has a feeding tube and is at risk for developing complications.

Goal:

Resident will maintain a residual less than 50 ml and achieve stable weight over the next 90 days.

Plan/Approach:

1. Complication Assessment:

   • Step-by-Step Approach: Regularly assess for any complications related to the feeding tube.
   • Monitoring Strategies: Document any signs of infection, leakage, or dislodgement.

2. Tube Maintenance:

   • Step-by-Step Approach: Replace the feeding tube if dislodged or leaking.
   • Technological Aids: Utilize feeding tube securement devices to minimize dislodgement risks.

3. Tube Flushing:

   • Step-by-Step Approach: Flush the tube as ordered to maintain patency.
   • Educational Efforts: Educate the resident and family on the importance of tube flushing to prevent blockages.

4. Head of Bed (HOB) Elevation:

   • Step-by-Step Approach: Keep the HOB elevated 30-45 degrees during and after feedings to prevent aspiration.
   • Technological Aids: Use adjustable hospital beds to ensure proper elevation.

5. Insertion Site Monitoring:

   • Step-by-Step Approach: Monitor the insertion site for signs of breakdown or infection.
   • Engagement in Diversional Activities: Encourage the resident to report any discomfort or changes at the site.

6. Site Treatment:

   • Step-by-Step Approach: Apply treatment to the PEG site as ordered to promote healing and prevent infection.
   • Monitoring Strategies: Regularly assess the effectiveness of the treatment.

7. Dietary Consultation:

   • Step-by-Step Approach: Consult with a dietitian as needed to ensure proper nutritional intake.
   • Educational Efforts: Educate the resident and family on the nutritional plan and its importance.

8. Feeding Administration:

   • Step-by-Step Approach: Administer feedings as ordered, monitoring for any signs of intolerance.
   • Technological Aids: Use feeding pumps to control the rate of feeding.

9. Physician Notification:

   • Step-by-Step Approach: Notify the physician of any complications such as occlusion, leakage, dislodgement, or breakdown at the tube site.
   • Monitoring Strategies: Document all communications with the physician and any changes in the care plan.

Rationale:

• Complication Assessment: Early identification of complications can prevent more severe issues.
• Tube Maintenance: Ensures the feeding tube remains functional and secure.
• Tube Flushing: Prevents blockages, maintaining feeding efficiency.
• HOB Elevation: Reduces the risk of aspiration, ensuring safe feeding practices.
• Insertion Site Monitoring: Prevents and identifies infections or skin breakdown early.
• Site Treatment: Promotes healing and prevents further complications.
• Dietary Consultation: Ensures the resident receives adequate nutrition tailored to their needs.
• Feeding Administration: Monitors and ensures the resident tolerates feedings well.
• Physician Notification: Ensures timely medical interventions for complications.

Actions:

1. Complication Assessment:

   • Staff will assess for any complications related to the feeding tube.

2. Tube Maintenance:

   • Staff will replace the feeding tube if dislodged or leaking.

3. Tube Flushing:

   • Staff will flush the tube as ordered.

4. Head of Bed Elevation:

   • Staff will keep the HOB elevated 30-45 degrees during and after feedings.

5. Insertion Site Monitoring:

   • Staff will monitor the insertion site for breakdown.

6. Site Treatment:

   • Staff will apply treatment to the PEG site as ordered.

7. Dietary Consultation:

   • Staff will consult with a dietitian as needed.

8. Feeding Administration:

   • Staff will administer feeding as ordered.

9. Physician Notification:

   • Staff will notify the physician of complications such as occlusion, leakage, dislodgement, or breakdown at the tube site.