Trach pt./J tube/Heartrate ?

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Specializes in Stroke/Neuro.

I am a GN who just took the NCLEX today:bugeyes:. I currently have a job that is in homecare. The pt. is in a persistent vegetative state due to an overdose of dilaudid (negligence on hospital's part). He has a trach and is fed by a Jtube. My question is whenever I tube feed him his heart rate goes way up to around 100. He gets 296ml at 200 ml/hr three times a day. This patient lives with his parents and is 37 YO. The father is constantly coming in the room and telling me to shut off the TF when his HR is over 88. I think this is not necessary but he demands I shut it off for 5 minutes. Any ideas you can give me to try to keep his HR down?:bowingpur

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Specializes in Pediatrics Only.

I have never fed anyone through a Jtube that fast. (now mind you, I only do pedi but still..200cc an hour is FAST)

Are you sure its a JTube and not a G-tube??

The Jtube bypasses the stomach to the jejunum - it is not meant to expand.

The Gtube, which goes directly into the stomach, is meant to expand to tolerate that rate and amount.

A bolus feed though a Jtube is incorrect (which is what the 296cc @ 200cc/hr is). Jtube feeds should be continuous only.

Only Gtube feeds can be bolused.

The increased HR could be pain related to the fast fluid bolus.

Has anyone asked the dr about it?

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