Question about when to hold G tube feeding

[Mell Bell]

This was a test question yesterday, and it's really bothering me.

You go to administer a patient's g tube feeding, for which situation would you hold the feeding?

A. patient complains of constipation

B. you ausculatate swoosh of air over abdomen when administering 30cc air bolus

C. residual is 200mL when last feeding was 4 hours ago

I forget the last answer - but I put C. If residual was that high after 4 hours, wouldn't this mean that the stomach was not adequately emptying, or that there is a blockage?

[jrsmrs]

That would be my answer as well.

[caliotter3]

I agree. Residual is too high. Normally the doctor's order will give an amount of residual to hold the feeding. If it is not specified, then refer to your unit policy and procedure manual.

[NSALVADORE]

Agreed, and yes the doc usually will put parameters as to the amount of residual to hold for, also each hospital usually has a policy on when to hold.

[Mell Bell]

Got the results, I got an 84%, and I got the question wrong

The answer that I forgot was "Patient complains of nausea", and that's the right answer. If you administer a feeding to a patient who says their stomach hurts, there's a high risk of them vomiting, which brings about more problems.

I'm kicking myself for not getting it right - I should have known that!

200mL after 4 hours is not too high, but what you would do is just put back 150mL of the residual. (One of my clinical professors told me that she always puts ALL of it back, but for tests 150mL is the correct amount.)

Hopefully this will help someone else out!

[NSALVADORE]

We put it all back too! I think in my facility we hold for 400cc's off the top of my head. Yes Nausea makes sense, also diarrhea would be something you want to be careful with!

[Justanotherday]

Yes, that answer makes the most sense. Who wants to eat when they feel like throwing up?