K so I've got a peds case which requires me to feed them via gtube and administer their medications via gtube as well.
Now my main concern is I've not worked with Peds too much except during my clinicals and even then I never had a pt with a Gtube.
I just want to know exactly how I should go about doing these procedures with a child that is 1yr 7mos.
Is the flush amount for meds for more or less (than 15mL before and 30mL after)?
Is the flush amount between meds more or less (than 5mL)?
How much should, if I should, should I flush prior to feedings?
I'm a bit nervous and would like to know how experienced Ped nurses go about doing these procedures instead of reading a book about it.
Oct 25, '13
You should have very specific fluid orders for any pedi patient. My patient (under age 3) had ICP issues and we did not have pre-med or feed flushes, no between med flushes. Prior to having a G button flushes were 5mL post med and 8mL post feed to endure no meds or formula were left in the extension tubing. (The extension tubing was approx 5mL). Once switched to GB flushes were reduced to 3mL and 5mL. We also had a daily fluid goal that had to be met through a combination of feeds, meds & flushes. This sounds like a private duty pediatrics case (there is a private duty specialty forum here on AN). The care plan/485 should have specific orders for fluids and flushes. With pedi patients, especially complex pedi, each child is unique and their orders are specific. I had two patients. Both former NICU preemie patients. Both with g-buttons. Both with specific fluid requirements but different reasons. (One had renal & renal hypertension as well as malabsorption issues, patient 2 had GI motility, neuro and ICP issues). Their enteral formulas and feed orders (rate & volumes) could not be more different. Their calorie counts were similar If this is a home care private duty case (shift work) consult with the clinical supervisor if the 485/care plan is not clear. Children are stable until they are not. Children are not mini adults and this is often the biggest learning area for nurses transferring from adults and even adolescent care to young child home/private duty care. Adults have more reserves.
Last edit by JustBeachyNurse on Oct 25, '13