G tube bolus feeding and other ques.

[jschut, BSN, RN]

I have a question (or 2 or more!)

Mom had a G tube placed last month after her cancer surgery.

She receives Perative 5x day.

#1) How much water should she be getting? Mom has always been a big water drinker, and I want to keep her well hydrated through this mess...

Her stools have been pretty loose, but she just went through a course of Augmentin too (finished now). If this continues, what can I give her to firm it up? I was giving her Immodium, it would help short term.

#2) Also, when she was in the hospital, she was put on insulin (reg~sliding scale) before each feeding. Now her doc has her on Lantus 20U qAM. Never before was she diabetic. This is a sudden change for her (in addition to everything else). Could the formula itself be causing the increased blood sugars? Should I ask the doc to maybe give her Diabetasource instead of Perative to see if the levels go down? I just can't help but wonder if the formula is what's causing her to have increased blood sugars and she really DOESN'T have diabetes. She's not been tested.

#3) Since Reglan helps with peristalsis in the upper GI tract, is there another med that does the same? Mom has been having quite a few bouts of confusion (and diarrhea) and I am wondering if it could be the cause. Maybe we could try something else.

I sure would appreciate everyones input on this. It just doesn't seem that I am getting too much cooperation from the doctors and frankly, they are starting to pi** me off!

I'd like to be armed with ideas to try before I go back again to try and reason with them for some changes.

Thanks again everyone!

[jmgrn65, RN]

I have a question (or 2 or more!)

Mom had a G tube placed last month after her cancer surgery.

She receives Perative 5x day.

#1) How much water should she be getting? Mom has always been a big water drinker, and I want to keep her well hydrated through this mess...

Her stools have been pretty loose, but she just went through a course of Augmentin too (finished now). If this continues, what can I give her to firm it up? I was giving her Immodium, it would help short term.

#2) Also, when she was in the hospital, she was put on insulin (reg~sliding scale) before each feeding. Now her doc has her on Lantus 20U qAM. Never before was she diabetic. This is a sudden change for her (in addition to everything else). Could the formula itself be causing the increased blood sugars? Should I ask the doc to maybe give her Diabetasource instead of Perative to see if the levels go down? I just can't help but wonder if the formula is what's causing her to have increased blood sugars and she really DOESN'T have diabetes. She's not been tested.

#3) Since Reglan helps with peristalsis in the upper GI tract, is there another med that does the same? Mom has been having quite a few bouts of confusion (and diarrhea) and I am wondering if it could be the cause. Maybe we could try something else.

I sure would appreciate everyones input on this. It just doesn't seem that I am getting too much cooperation from the doctors and frankly, they are starting to pi** me off!

I'd like to be armed with ideas to try before I go back again to try and reason with them for some changes.

Thanks again everyone!

Some of your questions only her Doc, should be answering. I can tell you Reglan does cause confusion and diarrhea.

I understand how frustrating it is when the docs don't talk with you but just keep at them. I don't think the rest of your question we can answer, sorry.

[Tweety, BSN, RN]

Could you call the dietician at the hospital? I know our dietcians don't mind getting calls from d/c'd patients. She/he might be able to recommend the amount of free water necessary.

Changing feedings would indeed be a question for the MD.

I usually hold reglan in patients with diarrhea, especially if there are no gastric volume residuals. Yes it can cause confusion.

[jschut, BSN, RN]

Could you call the dietician at the hospital? I know our dietcians don't mind getting calls from d/c'd patients. She/he might be able to recommend the amount of free water necessary.

Thanks Tweets! I'll try that today and see if they are able to tell me!

[traumaRUs, MSN, APRN]

I am so sorry about your dear mother. However, as the above posters stated, we can't provide medical advice. Please take. care.