Page 423 - Nutrition Essentials for Nursing Practice

C H A P T E R 1 5 Feeding Patients: Oral Diets and Enteral and Parenteral Nutrition 411

Table 15.7 Troubleshooting Nutrition-Related Problems in Tube-Fed Patients (continued)

Potential Problem Rationale Nursing Interventions and Considerations

Dry mouth Altered body image Encourage the client to leave the room when
Loss of control; fear others are eating and find other enjoyable
activities.
Limited mobility
Discomfort related to tube or Encourage client and family to view tube
feeding as another way of eating, rather
formula intolerance than a form of treatment.

Irritation of the mucous mem- Encourage client to verbalize his/her
branes related to lack of oral feelings.
intake
Stress positive aspects of tube feeding.
Breathing through the mouth
Encourage client to become involved in
preparation and administration of the
formula, if possible.

Inform client of problems that may occur and
how to prevent or cope with them.

Encourage socialization with other well-
adapted tube-fed clients.

Encourage normal activity.

Control gastrointestinal symptoms, such as
diarrhea, nausea, vomiting, and constipa-
tion, that interfere with normal activity.

Observe for intolerances; alleviate with
appropriate interventions.

Be sure to inspect and properly care for
the tube exit site to avoid potential
complications.

Encourage good oral hygiene to alleviate
soreness and dryness: mouthwash, warm
water rinses, regular brushing.

Apply petroleum jelly to the lips to prevent
cracking.

Allow ice chips, sugarless gum, and hard
candies, if possible, to stimulate salivation.

Encourage client to breathe through the nose
as much as possible.

Box 15.4 CONSIDERATIONS FOR GIVING MEDICATIONS THROUGH A
FEEDING TUBE

■ Drugs absorbed from the stomach should never be given through a nasointestinal
tube.

■ The liquid form of a medication diluted with 30 mL of water should be used for feed-
ing tube administration. If there is no alternative, a drug can be crushed to a fine
powder and mixed with water before it is administered. Slow-release drugs should
never be crushed.

■ Dilute highly viscous and hyperosmolar liquid medications with 10 to 30 mL of water
before administering.

■ Drugs should be given orally whenever possible.

■ Tube feeding may need to be temporarily stopped to permit drug administration on
an empty stomach or to avoid drug–nutrient interaction. Some experts recommend
stopping a continuous feeding for 15 minutes before and after the delivery of the
medication.