Peg tube bolus feeding

Esme12, ASN, BSN, RN · Dec 10, 2014

Is there any other information/assessment?

Esme12, ASN, BSN, RN · Dec 10, 2014

I mean displaced where? Do you have residual? If so how much?

Graduation2016 · Dec 10, 2014

Hi Esme, I have changed the diagnosis to constipation due to delayed gastric emptying. Only info I have is that the patient is staring he is full and he does have some bowel sounds, that is all I have, that is what is so hard for me to make up the story in order to come up with a diagnosis and care plan. I elaborated based on the diagnosis I changed it to.

Lev, MSN, RN, NP · Dec 11, 2014

Constipated from his tube feed? Usually, it's the other way around...

Graduation2016 · Dec 11, 2014

Well, that's all I could find, maybe I'm looking in the wrong place. What are other causes of having a distended abdomen but bowel sounds present while having a peg tube? I'm dying here! Lol

dah doh, BSN, RN · Dec 11, 2014

Perhaps you need to rethink your made up patient. A 26 y.o. has a G-tube with a h/o anorexia? Seems a bit extreme for such a young patient. Any other medical history?

Displaced G-tube and you're worried about constipation? Tube feeding usually causes diarrhea. Displaced G-tube meaning it fell out? Or displaced G-tube like it slipped into the fascia? Then I'd worry more about peritonitis!

IrishIzCPNP, MSN, RN, APRN, NP · Dec 11, 2014

Was there information you were given and then you had to add onto the info to make a case?

Graduation2016 · Dec 11, 2014

Again, the only info I was given is this: you are preparing to give a scheduled bolus feeding to a patient. He then states he feels too full to have another feeding and his last one was 4 hours ago. Abdomen is somewhat distended but there are bowel sounds present. What would cause the fullness and the distention on this patient?

I made up the part of being 26 and with a hx of anorexia just to add something to it. The tube displacement was my first choice for a diagnosis but it was getting too complicated to keep on elaborating. From what I read some types of formula may cause constipation that is why I switched.

Lev, MSN, RN, NP · Dec 11, 2014

A more like candidate for this case would be a 82 year old man with a history of aspiration pneumonia.

Esme12, ASN, BSN, RN · Dec 11, 2014

Well, that's all I could find, maybe I'm looking in the wrong place. What are other causes of having a distended abdomen but bowel sounds present while having a peg tube? I'm dying here! Lol

A patient with a distended abdomen can still have a bowel obstruction/ileus.

I would go more for an elderly patient with CVA swallow difficulties and PEG tube with ileus/bowel obstruction and high tinkling bowel sounds auscultated and large residual complaining of nausea/vomiting.

IrishIzCPNP, MSN, RN, APRN, NP · Dec 11, 2014

Again, the only info I was given is this: you are preparing to give a scheduled bolus feeding to a patient. He then states he feels too full to have another feeding and his last one was 4 hours ago. Abdomen is somewhat distended but there are bowel sounds present. What would cause the fullness and the distention on this patient?
I made up the part of being 26 and with a hx of anorexia just to add something to it. The tube displacement was my first choice for a diagnosis but it was getting too complicated to keep on elaborating. From what I read some types of formula may cause constipation that is why I switched.

See what you were adding creates more confusion and an odd case...versus something realistic.

Chances are the feeding tube is related to a medical condition where eating is dangerous or the person can't physically eat. Anorexia and a feeding tube...can happen but not as likely.

So think of conditions which would be more likely to cause a need for a feeding tube. Think of why that abdomen might be distended. Formulas can constipated but frequent they go the other way.