Peg tube bolus feeding

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Hello! Working on my last med/Surg case study and I'm a little blocked. My pretend pt is due for a bolus feeding but he states he feels full. Abdomen somewhat distended but bowel sounds are present. Since I'm making up the case, I pretended this is a 26 y/o male who has a hx of anorexia. It was discovered that his tube is displaced. I'm having a hard time elaborating on this. Tips? Thanks in advance!

Specializes in Complex pedi to LTC/SA & now a manager.

First check residual. Distention could be r/t retained gas from swallowed air especially if a mouth breather. When you vent the GT to check residual you may "decompress" the distention. You can decide your next steps based upon the residual volume. Often if > 50% last feed volume return and check in 30-60 min. Some times the order is to discard excess residual. If no gas or residual it's possible GT is displaced but that is not a nursing Dx.

If looking for a nursing diagnosis to expand on look at gastric dysmotility and the r/t factors. Gastric dysmotility is a nursing diagnosis

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Specializes in OB.

These ideas are great! Thanks everyone! I guess I was overthinking it way too much!

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Specializes in Complex pedi to LTC/SA & now a manager.

Is easy to get excited and over complicate things.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
These ideas are great! Thanks everyone! I guess I was overthinking it way too much!

((HUGS)) You're almost there!

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Specializes in OB.

Thanks Esme! I did make changes to my pretend patients story and ended up getting an A in my presentation. Thanks again everyone! One more week and med/Surg will be DONE!!! Bring on OB and Peds! Woohoo!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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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.

"Tube displacement" is not a nursing diagnosis.

He could have swallowed a lot of air from anxiety. Tap over his abdomen and see what it sounds like-- hollow or solid? (Since this is imaginary, your choice). :) Sit him up to burp, or aspirate from the tube ...

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