laryngectomy pt with PEG-tube

[chellelynn25]

I recently had a pt 2 years s/p laryngectomy and peg-tube placement admitted to my unit. She came to my facility on minimal meds and an order for Glucerna 2.1 240ml 4xs daily. She came to my facility after a lengthy stay in the hospital after she had become depressed and stopped giving full amounts of feed. She now weighs 74.6 lbs She communicates with a pad and a pen, and IMO is the cutest, friendliest little lady I have had placed on my unit in a while. Now she is in better spirits and at my facility to rehab home. My question is this. Has anyone ever had a pt or placed pureed foods, i.e. ice cream jello soup etc down their tube? She says this something that she used to due at home. She says that the Glucerna does not "fill" her up and gives her diarrhea. I suggested that I get an order to increase the Glucerna but she declined. She is A and O x3. Our house MD gave me an order for a dietary and Speech therapy consult to address it. I feel terrible for her b/c she frequently complains that she is hungry in between tube feeds. She is basically self care she does all trach care herself including suction. Anyone have any input?

[leslie :-D]

i just can't see pureed foods being able to go down a g-tube, w/o getting clogged.

the dietitician should devise a poc that will help this pt, but my first thought was adding fiber.

hope your pt is feeling better soon.

leslie

[annaedRN, RN]

fiber is what i thought too. check her prealbumin level - if her nutrition is adequate- then maybe more fluids overall may be the trick (or some extra supplements)...sometimes thirst is mistaken for hunger. Maybe it needs to be something other than Glucerna? maybe alter the feeding schedule - more often but slightly lesser amts each time to keep her fuller between?