Enteral Nutrition: Types and Methods

Enteral Nutrition

• Enteral nutrition is the delivery of nutrients to the GI tract, keeping the GI system functioning and gastric motility working.
• Preferred method of artificial nutrition, especially for short-term feedings.

Types of Enteral Tubes

• NG tubes: suitable for short-term feedings.
• Percutaneous tubes (e.g., peg tube, G tube, GJ tube): preferred for long-term feedings (> 4 weeks).
• Percutaneous tubes reduce skin and esophagus irritation and pressure injuries associated with NG tubes.

Best Practices for Enteral Nutrition

• Elevate the head of the bed to 30-45 degrees to decrease aspiration risk.
• Aspirate gastric contents before each feed to check for residual volume and potential GI problems.
• If gastric residual volume is >500mL, do not return it to the stomach and notify the provider.
• Flush the tube with 30mL of water before and after every feeding, medication administration, and gastric residual volume checks.
• Change tubing and delivery sets every 24 hours to prevent microbial growth.
• Refrigerate and discard open cans of formula after 24 hours.

Parenteral Nutrition

• Parenteral nutrition delivers nutrients directly to the bloodstream, circumventing the GI tract.
• Requires a central line (PICC line or central venous catheter) for administration.

Important Considerations for Parenteral Nutrition

• Monitor glucose levels to ensure the patient is receiving adequate nutrition and to prevent complications.
• Discard Total Parenteral Nutrition (TPN) bags after 24 hours to prevent microbial growth due to bacterial growth in high-glucose solutions.
• If the next TPN bag is unavailable, administer 10-20% dextrose in water until it becomes available, following facility policies and orders.

Enteral Nutrition

• Delivers nutrients to the GI tract, maintaining its function and gastric motility
• Preferred method for short-term feedings and when the GI system is functional

Types of Enteral Tubes

• NG tubes: suitable for short-term feedings
• Percutaneous tubes (e.g., peg tube, G tube, GJ tube): preferred for long-term feedings (> 4 weeks)
• Percutaneous tubes reduce skin and esophagus irritation and pressure injuries associated with NG tubes

Best Practices for Enteral Nutrition

• Elevate the head of the bed to 30-45 degrees to decrease aspiration risk
• Aspirate gastric contents before each feed to check for residual volume and potential GI problems
• If gastric residual volume is >500mL, do not return it to the stomach and notify the provider
• Flush the tube with 30mL of water before and after every feeding, medication administration, and gastric residual volume checks
• Change tubing and delivery sets every 24 hours to prevent microbial growth
• Refrigerate and discard open cans of formula after 24 hours

Parenteral Nutrition

• Delivers nutrients directly to the bloodstream, circumventing the GI tract
• Requires a central line (PICC line or central venous catheter) for administration

Important Considerations for Parenteral Nutrition

• Monitor glucose levels to ensure the patient receives adequate nutrition and to prevent complications
• Discard Total Parenteral Nutrition (TPN) bags after 24 hours to prevent microbial growth due to bacterial growth in high-glucose solutions
• If the next TPN bag is unavailable, administer 10-20% dextrose in water until it becomes available, following facility policies and orders