Gastrointestinal Question #3
A client diagnosed with pancreatitis is experiencing watery diarrhea after two days of initiating continuous enteral feedings via gastrostomy tube. Which physician order will the nurse act upon next?
- Flush tube with 50 mL water as needed and keep head of bed elevated.
- Decrease feeding rate, and titrate rate to increase by 10 mL each 8 hours up to 60 mL/ hr.
- Hold feedings for residual greater than 100 mL.
- Place client on NPO (nothing by mouth).
Clients may require rate adjustments for enteral tube feeding solution during initial feedings. Feedings may begin at 20-40 mL and according to caloric needs. Nursing should not dilute feedings unless specifically ordered since diluting solution will change the tonicity of the formula. Likewise all medications require diluting per policy since some may cause diarrhea because of the medication tonicity. Continuous pump feedings can reduce gastrointestinal discomfort and maximize absorption. While tube flushing, and residual volume checking are important (options A and C), these actions do not constitute the most important next actions by the nurse for diarrhea. Placing the client on NPO will further compromise nutritional status unless the provider is scheduling specific testing and/or surgery.