About
Surgical opening made from the exterior abdomen wall into the jejunum and insertion of a catheter for the administration of enteral nutrition and/ or medications.
Assess
Site of insertion for signs and symptoms of infection, bowel sounds, fluid volume balance, intake and output, residual volume after administration of feedings, pain levels, vital signs
Complications
Tube dislodgement, aspiration, dumping syndrome, infection, abdominal cellulitis, diarrhea, constipation, poor tolerance to supplements, body image disturbance
Diagnosis
- Impaired skin integrity related to surgical opening
- Nutrition deficit less than body requirements related to impaired oral consumption
- Risk for infection related to invasive procedure and portal of entry from catheter
- Body image disturbance related to mechanism of eating.
Goals
- The client will state a decrease in pain using a 0-10 visual analogue scale.
- The client will be able to demonstrate how to care for enteral tube and surrounding skin.
- The client will be able to state three symptoms of infection that require immediate follow-up.
- The client will be able to state feeding techniques and frequency.
Interventions
- Assess client for signs and symptoms of infection including redness, swelling, drainage around insertion site, fever, elevated white blood cell count.
- Assess intake and output, vital signs, electrolytes, bowel sounds, and pain levels.
- Assess understanding of surgical procedure and post-operative care.
- Administer feedings and medication as prescribed by health care provider.
- Monitor for impaired tolerance to feedings such as constipation, nausea, emesis, dumping syndrome, increased residual volumes ( greater than 200cc's), decreased bowel sounds, abdomen distention.
- Change the dressing and all feeding supplies daily.
- Teach the client how to care for tube and signs and symptoms of infection to be vigilant for.
- Encourage client to verbalize concerns, fears, and feelings regarding surgical procedure.
- Maintain head of bed at 30-45 degrees during and after feedings to prevent aspiration.
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