Enteral Feeding

An Overview: What is Enteral Feeding?

Enteral feeding refers to the delivery of nutritionally complete feed, containing protein, carbohydrate, fat, water, minerals and vitamins, directly into the gut via a tube. It plays a key role in maintaining nutritional health of patients who can't consume food orally.

The Importance of Enteral Feeding in Nursing

Understanding the role and importance of enteral feeding in nursing is essential. Proper nutrition is critical for patient recovery, particularly in intensive care settings where patients may be incapable of conventional eating due to critical illness or surgery.

Getting to Grips with the Enteral Feeding Tube

Enteral feeding tubes serve as a bridge between the patient and their nutritional needs. The tubes can be small-bore or large-bore and can be inserted via the nose, mouth or directly into the stomach or small intestine.

• Nasogastric Tube: Inserted via the nose, down the esophagus and into the stomach.
• Orogastric Tube: Inserted via the mouth and into the stomach.
• Gastrostomy Tube: Inserted directly into the stomach through the abdominal wall.
• Jejunal Tube: Inserted into the middle part of the small intestine (jejunum).

Safely Administering Enteral Feeding Tubes

Administering enteral feeding tubes is a crucial nursing skill. It should be performed with utmost care to avoid complications such as aspiration pneumonia, diarrhoea, electrolyte imbalances, and occlusion of the tube.

Remember, enteral feeding requires meticulous care and attention to ensure patient safety and wellbeing. As future nurses, developing a strong knowledge foundation and skill set in this area is crucial for providing high-quality care.

Navigating Parenteral vs Enteral Feeding in Nursing

Working as a nursing professional, you'll often encounter situations where both enteral and parenteral feeding methods are considered. Both strategies aim to provide nutrition to patients who cannot consume food orally, but they employ different methods and have varying benefits and challenges.

Pros and Cons of Enteral and Parenteral Feeding

Choosing between these two feeding methods requires a detailed understanding of their respective advantages and drawbacks.

Enteral Feeding: Pros and Cons

Enteral feeding works by delivering nutritionally complete food directly into the gut through a tube. This method is generally preferred as it utilises the natural digestive system, maintains gut integrity and promotes the growth of beneficial gut bacteria.

• Pros: More physiological, cost-effective, lower risk of infections compared to parenteral feeding.
• Cons: May cause discomfort, risk of aspiration pneumonia, not suitable for patients with severe gastrointestinal disorders.

Parenteral Feeding: Pros and Cons

Parenteral feeding is the administration of nutrients intravenously, bypassing the usual process of eating and digestion. This is essential in individuals where the gut cannot be used for food intake due to severe illness or surgery.

• Pros: Provides nutritional support when oral or enteral feeding is contraindicated, allows precise control of nutrient intake.
• Cons: More expensive, increased risk of infections, may lead to liver complications.

Key Differences Between Parenteral and Enteral Feeding

Understanding the key differences between enteral and parenteral feeding can aid your decision-making process.

For a safe and effective nursing practice, gaining a comprehensive understanding of these two feeding methods, their contexts of use, and implications on patient health, is of paramount importance.

Utilising the Enteral Feeding Pump in Nursing

Having in-depth knowledge and experience in the utilisation of the enteral feeding pump is an imperative skill in the nursing profession. These pumps are used to deliver nutrition accurately and continuously into the gut, facilitating improved patient nutritional health and supporting recovery.

Understanding how an Enteral Feeding Pump works

As you venture into the use of enteral feeding pumps, it's crucial to understand their mechanics and function. The enteral feeding pump operates by precisely delivering a specified volume of enteral feed into the patient's gastrointestinal tract over a predetermined period. Most pumps are electronically powered, with handheld versions offering portability and convenience.

The equipment usually consists of a feeding bag, a hanging pole, a set of tubing, a pump, and the feeding tube itself. The feed - usually a liquid nutrition mix - is stored in the feeding bag, suspended from the pole. The tube carries the feed from the bag to the patient's body. The pump controls the speed at which the feed is delivered through the tube.

Knowing the components and their functions is a prerequisite for secure handling and utilisation of the feeding pump. Remember, the goal is to ensure that the patient receives the right amount of nutrition at the right time.

Safe Practices for using an Enteral Feeding Pump

Operating an enteral feeding pump entails responsibility. It's crucial to adhere to standard safety practices, ensuring the patient's wellbeing while using the pump.

Before initiating the feed, always verify the correct patient, the correct feed, and the correct pump settings. Using aseptic technique when handling the enteral feed and the feeding pump is critical to reducing the risk of infection.

Before and after administering the feed or medication, the feeding tube should be flushed with water. This helps maintain tube patency and facilitates proper absorption of the medication.

Checking for signs of tube displacement, blockages, or any adverse reactions must be conducted regularly. Monitoring the patient’s tolerance to the feed is also an essential aspect, identified by observing the presence of discomfort, distention, nausea or vomiting. Documentation of the entire process is invaluable for continuity of care and evaluation of the nutrition support strategy.

There's no room for complacency when it comes to feeding your patients. Grasping sound knowledge of these best practices in enteral feeding pump usage is imperative in nursing, as they constitute the frontline support to patient's nutrition and recovery.

Exploring Enteral Feeding Formulas in Intensive Care Nursing

In your journey as a budding nursing professional, gaining insights about enteral feeding formulas broadens your understanding of patient nutrition. Let's explore these essential elements needed for patient recovery in an intensive care setting.

Different Types of Enteral Feeding Formulas

Enteral feeding formulas are specially designed, nutritionally complete and balanced diets prescribed to patients who can't eat normally. These formulas vary according to nutritional composition and other special characteristics, catering to the varied needs of patients.

Primarily, enteral formulas are divided into three categories: polymeric, semi-elemental and elemental.

• Polymeric formulas: Also known as standard formulas, they are made up of whole proteins, carbohydrates and fats. They are suitable for patients with a healthy, functional gastrointestinal tract.
• Semi-elemental formulas: These contain partially broken-down proteins and simple sugars, making them easier to digest and absorb. They are used for patients with impaired digestion or absorption.
• Elemental formulas: These consist of very basic forms of nutrients (amino acids, simple sugars), requiring minimal digestion. They are used for patients with severely impaired digestive function.

Selecting the Right Enteral Feeding Formula

Selecting the appropriate enteral feeding formula involves consideration of several factors such as patient's nutritional needs, their underlying health conditions, gastrointestinal function and the ability to handle certain nutrient compositions. Coordination with the healthcare team, especially the dietitian, is crucial in this process.

In nursing practice, selecting the right enteral feeding formula can significantly impact patient recovery. Through cooperation with the healthcare team and the careful evaluation of various patient factors, you can help ensure that the chosen formula best aligns with the patient's nutrition goals.

Analysing Types of Enteral Feeding and Enteral Feeding vs TPN

Digging deeper into the concept of enteral feeding leads us to a comparison with another form of nutrition therapy, Total Parenteral Nutrition (TPN). You'll find that understanding these approaches not only enriches your foundational nursing knowledge, but significantly contributes to your patient management skills. So let's discover more.

Understanding the Different Types of Enteral Feeding

The method of enteral feeding chosen for a patient depends largely on the patient's gastrointestinal anatomical integrity, disease type, and overall clinical condition.

Primarily, there are three types of enteral feeding methods – Nasoenteric feeding, Gastric feeding, and Jejunal feeding.

• Nasoenteric (or nasogastric/nasojejunal) feeding: A tube is passed through the nose, down the oesophagus and ends either in the stomach (nasogastric) or passed further into the jejunum (nasojejunal). Suited for short-term use, most common in acute conditions.
• Gastric (or gastrostomy) feeding: A tube is introduced directly into the stomach through the abdominal wall. Preferred for long-term home enteral nutrition or patients with risk of aspiration.
• Jejunal (or jejunostomy) feeding: A tube is inserted directly into the jejunum through the abdominal wall. This method is utilised when gastric feeding isn't possible due to stomach dysfunction or risk of aspiration.

Debunking the Enteral Feeding vs TPN Debate

When oral or enteral nutrition is not feasible, another method called Total Parenteral Nutrition (TPN) comes into play. TPN is a way of supplying all daily nutritional needs via a catheter placed into a central vein, bypassing the digestive tract.

The debate between enteral feeding and TPN doesn't yield a one-size-fits-all answer. The choice largely depends on the patient's individual situation and the potential risks and benefits of each method. As a nursing professional, your role is to understand these nuances, work collaboratively with the healthcare team, and advocate for the best approach tailored to your patient's needs.