Enteral Nutrition Administration

00:10:29
https://www.youtube.com/watch?v=rZxlSgaujA4

Summary

TLDRCette vidéo pédagogique explique comment administrer une alimentation entérale à travers une sonde naso-gastrique (NG) en se concentrant sur les étapes cruciales du processus. D'abord, il est nécessaire de vérifier le positionnement correct de la sonde à l'aide d'un test de pH ou d'une mesure physique, conformément aux politiques de l'établissement. Une évaluation gastro-intestinale du patient est également cruciale, englobant l'écoute des bruits intestinaux et une évaluation des symptômes tels que ballonnements ou crampes. Pour garantir le bon fonctionnement du processus, il est important de rincer la sonde avec de l'eau stérile avant et après l'alimentation pour assurer sa perméabilité. L'alimentation est administrée par gravité et les précautions d'hygiène nécessaires, comme le lavage des mains, doivent être suivies pour préserver la stérilité.

Takeaways

  • 🩺 Vérifiez toujours l'emplacement de la sonde NG avant de commencer.
  • 📏 Mesurez la longueur de la sonde pour assurer sa bonne position.
  • 🔊 Écoutez les bruits intestinaux pour évaluer la santé gastro-intestinale.
  • 🚰 Rincez la sonde avec de l'eau stérile avant de commencer.
  • 📄 Suivez les directives et prescriptions du médecin pour la formule d'alimentation.
  • 💧 Utilisez une seringue de 60cc pour l'administration par gravité.
  • ⏲️ Attendez 30 à 60 minutes avant de reconnecter à l'aspiration si nécessaire.
  • 📋 Documentez tous les détails de l'administration dans le dossier du patient.
  • 🛏️ Assurez le confort du patient après le processus.
  • 🛎️ Laissez la sonnette d'appel à portée du patient après l'alimentation.

Timeline

  • 00:00:00 - 00:05:00

    Cette compétence se concentre sur l'alimentation entérale d'un patient avec une sonde naso-gastrique (NG). Avant l'administration de quoi que ce soit dans la sonde, il est crucial de vérifier que la sonde est toujours en place, c'est-à-dire dans l'estomac, généralement par des tests de pH ou des mesures comparées à une radiographie. Un bon examen gastro-intestinal préalable est également essentiel, tout comme la vérification de la bonne formule d'alimentation et de l'identification du patient, y compris les allergies. L'usage de l'équipement correct, comme une seringue de 60 cc, est important pour gérer la pression lors de l'administration par gravité ou avec une pompe.

  • 00:05:00 - 00:10:29

    Assurez-vous que la sonde est perméable en injectant d'abord 30 cc d'eau stérile. Ensuite, selon les prescriptions, administrez l'alimentation par gravité après avoir vérifié tous les détails de la formule à utiliser. Après l'administration, il est essentiel de rincer la sonde avec 30 cc d'eau pour maintenir la perméabilité de la sonde. Attendez un peu avant de rebrancher à l'aspiration si nécessaire, et documentez tous les aspects de la procédure, y compris les réponses du patient, qui peut exprimer des gênes comme des crampes ou des ballonnements.

Mind Map

Mind Map

Frequently Asked Question

  • Quel type de tube est utilisé pour l'alimentation entérale dans cette vidéo ?

    La vidéo utilise une sonde naso-gastrique Salem pour l'alimentation entérale.

  • Comment vérifie-t-on le positionnement correct de la sonde NG ?

    Le positionnement correct de la sonde est vérifié par les méthodes de politique de l'établissement, comme le test de pH ou la mesure de la sonde.

  • Quels signes gastro-intestinaux sont évalués avant l'alimentation ?

    Les bruits intestinaux sont écoutés et on interroge le patient sur les symptômes de ballonnements, crampes ou diarrhée.

  • Quelle précaution doit être prise concernant le tube avant de commencer l'alimentation ?

    Il est essentiel de s'assurer que le tube est perméable en le rinçant avec de l'eau stérile.

  • Pourquoi est-il important de rincer la sonde avant et après l'alimentation ?

    Rincer la sonde avant et après l'alimentation assure qu'elle reste perméable et ouverte.

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  • 00:00:14
    all right so this skill is going to be
  • 00:00:16
    focusing on how to provide a patient
  • 00:00:19
    with enteral feeding this particular
  • 00:00:21
    patient has a ng tube in
  • 00:00:24
    and this as you can see is a salem a
  • 00:00:27
    salem pump tube um but it can be
  • 00:00:30
    utilized for tube feedings as well
  • 00:00:32
    especially when the tube feeding is
  • 00:00:33
    short-term so just a few
  • 00:00:36
    few pieces of information regarding
  • 00:00:39
    ng tube
  • 00:00:40
    first of all when a patient has an ng
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    tube before you are going to put
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    anything into that tube you have to make
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    sure that it is still in the correct
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    spot so ng means that it goes through
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    the nairs into the stomach so you want
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    to make sure that it's staying in the
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    stomach there's a couple of ways that
  • 00:00:57
    you can verify placement
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    and that would be per your facilities
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    policy that would either be by doing ph
  • 00:01:04
    testing
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    and that that's one way of doing it the
  • 00:01:07
    other way that you can do it is by
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    measuring
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    the tube so once it's been verified that
  • 00:01:13
    it's in the stomach using a x-ray
  • 00:01:16
    then you would go ahead and mark at the
  • 00:01:19
    tube where right up to the nearest where
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    it's inserted and measure that
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    so you would go ahead and measure
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    how long the tube is
  • 00:01:30
    coming out of the nose
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    to the end and then you would document
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    that in the patient's chart so that each
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    time a nurse
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    goes in to put something in the tube
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    they can measure it to make sure that
  • 00:01:43
    that that measurement stays consistent
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    so that we know that the tube hasn't
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    moved
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    all right we also before we want to put
  • 00:01:51
    anything in the tube is we want to do a
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    gastrointestinal assessment so that
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    would include making sure that you
  • 00:01:57
    listen to the lung listen to the bowel
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    sounds and make sure that those are
  • 00:02:02
    present you also want to ask the patient
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    if they're having any bloating or
  • 00:02:05
    cramping or maybe diarrhea
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    and then the other thing you want to do
  • 00:02:09
    is make sure that you're looking at
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    their the nares and making sure that
  • 00:02:14
    they're not swollen everything looks
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    patent
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    or if they're not having a lot of
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    discomfort
  • 00:02:21
    all right so when we're going to give
  • 00:02:23
    two feeding through an ng tube um
  • 00:02:25
    obviously you want to make sure that you
  • 00:02:27
    check the provider's orders and you want
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    to make sure that you have the correct
  • 00:02:31
    tube feeding formula and that you would
  • 00:02:34
    do the same as you with any medication
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    you would double check with your mar and
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    make sure you do your checks
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    and then if you when you come into the
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    patient's room and you're ready to give
  • 00:02:43
    them the two feeding you also want to
  • 00:02:44
    make sure that you check their
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    id to make sure that you verify their
  • 00:02:48
    name and date of birth
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    and also any allergies that they might
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    have okay
  • 00:02:54
    all right so now i think we're going to
  • 00:02:55
    begin
  • 00:02:57
    so i have all my equipment here
  • 00:03:00
    it's good practice to have some type of
  • 00:03:03
    either a towel or a
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    unabsorbable pad to put underneath
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    where you're going to be giving the
  • 00:03:17
    the feeding
  • 00:03:18
    so you want to make sure that you know
  • 00:03:20
    if you're doing it this way that you
  • 00:03:22
    have the pad under there
  • 00:03:24
    for our purposes we're going to be doing
  • 00:03:26
    this
  • 00:03:27
    via
  • 00:03:28
    kind of a simulated
  • 00:03:30
    way because we don't want the mannequin
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    to the mannequin isn't capable of taking
  • 00:03:35
    in two feedings so we're going to use
  • 00:03:37
    this as our simulation here all right
  • 00:03:40
    okay so we have all that and then we're
  • 00:03:43
    going to have a 60
  • 00:03:45
    lurlock syringe not lure lock i'm sorry
  • 00:03:48
    which is regular cc
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    60cc syringe
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    and it should be that large you don't
  • 00:03:54
    want any smaller syringes just stick
  • 00:03:56
    with the 60 cc because of the pressures
  • 00:03:58
    pressure gradients you also want to
  • 00:04:00
    check your policy as far as using tap
  • 00:04:02
    water versus sterile water
  • 00:04:04
    i'm using sterile water
  • 00:04:06
    and also you might want to have a
  • 00:04:10
    clamp
  • 00:04:10
    to put into your tube feeding if you
  • 00:04:12
    don't have one and you're measuring tape
  • 00:04:15
    before you come into the room
  • 00:04:17
    okay so now i'm gonna go ahead wash my
  • 00:04:19
    hands again quick and put my gloves on
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    because i verified placement and so the
  • 00:04:24
    tube is actually in the right place it's
  • 00:04:26
    in the stomach
  • 00:04:31
    i've already done my gi assessment and
  • 00:04:33
    asked my patient questions
  • 00:04:35
    regarding that
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    okay i'm going to be
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    providing the
  • 00:04:43
    two feeding formula
  • 00:04:45
    via gravity um you will also know that
  • 00:04:49
    we have
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    pumps two feeding pumps that we can use
  • 00:04:52
    that are similar to iv pumps
  • 00:04:53
    that actually pump the
  • 00:04:56
    fluid in however i'm going to do this by
  • 00:04:58
    gravity
  • 00:05:00
    all right so we want to make sure that
  • 00:05:01
    our tube is patent
  • 00:05:04
    so that means that we want to
  • 00:05:08
    draw up 30 cc's
  • 00:05:12
    of water
  • 00:05:13
    and
  • 00:05:15
    inject that into the
  • 00:05:17
    tube to make sure that it's open and
  • 00:05:19
    usable before we put the tube feeding in
  • 00:05:22
    and your sterile water you just want to
  • 00:05:23
    make sure it's not expired and it
  • 00:05:25
    shouldn't be open for more than uh 24
  • 00:05:27
    hours
  • 00:05:29
    always label when you open it the date
  • 00:05:32
    and the time
  • 00:05:33
    so that you can keep it under that 24 24
  • 00:05:36
    hours or under
  • 00:05:38
    all right so i basically just filled up
  • 00:05:41
    a medicine cup with 30 cc's of water
  • 00:05:46
    you may see that there are
  • 00:05:49
    specific containers that you can use too
  • 00:05:51
    to put your sterile water in instead of
  • 00:05:53
    drawing it right out of the container
  • 00:05:54
    you probably don't want to do that
  • 00:05:56
    all right so what we're going to do
  • 00:05:59
    retract myself here we're going to take
  • 00:06:01
    the plunger
  • 00:06:03
    just show you make sure it's nice and
  • 00:06:06
    flexible there and we're going to go
  • 00:06:07
    ahead
  • 00:06:11
    and draw up our 30ccs
  • 00:06:16
    and there might be some
  • 00:06:17
    air in there you can just push that air
  • 00:06:19
    out
  • 00:06:20
    so you don't want to give the patient
  • 00:06:21
    too much air
  • 00:06:23
    all right
  • 00:06:24
    and then
  • 00:06:25
    i'm going to take out this
  • 00:06:27
    little clamp thing here so that i can go
  • 00:06:29
    ahead
  • 00:06:30
    and
  • 00:06:32
    check for patency so basically i'm just
  • 00:06:34
    flushing the tube with
  • 00:06:37
    the sterile water
  • 00:06:39
    to make sure that it's fluent so i can
  • 00:06:41
    put my
  • 00:06:43
    tube feeding in there and so after you
  • 00:06:45
    put something in you always want to
  • 00:06:46
    clamp it afterwards so that it doesn't
  • 00:06:48
    backflow back out so always clamp after
  • 00:06:51
    you're done
  • 00:06:52
    now the next thing i'm going to do is
  • 00:06:54
    i've checked and did all my checks on my
  • 00:06:56
    formula
  • 00:06:58
    and i i noticed that what i'm going to
  • 00:07:00
    have to give this patient
  • 00:07:03
    is basically this
  • 00:07:06
    360 cc's of this
  • 00:07:10
    per my order
  • 00:07:12
    and i'm going to do this by gravity
  • 00:07:16
    so i'm going to take out the plunger
  • 00:07:18
    since i'm doing it by gravity
  • 00:07:20
    keeping it clamped
  • 00:07:22
    your tubing clamped you're going to go
  • 00:07:23
    ahead and put the syringe
  • 00:07:25
    right onto the tubing
  • 00:07:30
    okay
  • 00:07:31
    and i'm not sure how this is going to
  • 00:07:32
    work for me here real well here but i'm
  • 00:07:34
    going to go ahead and
  • 00:07:37
    um
  • 00:07:38
    excuse i'm just going to grab this here
  • 00:07:40
    real quick
  • 00:07:42
    and i'll measure the amount on my
  • 00:07:44
    syringe to be most accurate
  • 00:07:49
    okay
  • 00:07:50
    so basically you're just gonna pour that
  • 00:07:53
    in it's it's not on
  • 00:07:54
    let's just say it's still clamped
  • 00:07:58
    okay so then when you're ready to go and
  • 00:08:00
    you unclamp it
  • 00:08:02
    and i put the 60cc in
  • 00:08:05
    and i'm just basically
  • 00:08:07
    administering it by gravity and it'll go
  • 00:08:09
    into the stomach that way
  • 00:08:10
    versus being pumped through with a pump
  • 00:08:15
    okay when that goes in
  • 00:08:17
    i'm going to clamp it
  • 00:08:20
    so you would clamp it
  • 00:08:22
    take this off
  • 00:08:24
    and then i'd have to flush it one more
  • 00:08:25
    time after i'm done giving the feeding
  • 00:08:27
    to keep the
  • 00:08:29
    tube patent
  • 00:08:31
    just put this over here
  • 00:08:34
    and then i'm going to go ahead and flush
  • 00:08:36
    it with 30 more cc's
  • 00:08:41
    it's always flush before and after
  • 00:08:43
    you're administering anything
  • 00:08:46
    so i got my 30cc there
  • 00:08:52
    okay and then i can also flush by
  • 00:08:54
    gravity as well so when i initially did
  • 00:08:56
    it i did it by you know force by pushing
  • 00:08:59
    it in but you can also flush with
  • 00:09:01
    gravity as well
  • 00:09:06
    so i'm gonna flush with my 30 cc's
  • 00:09:11
    and let that go through
  • 00:09:16
    okay so now the flush is completed
  • 00:09:18
    so i'm done with that so you want to
  • 00:09:20
    make sure it's clamped
  • 00:09:24
    okay
  • 00:09:26
    and now the patients just had their two
  • 00:09:28
    feeding
  • 00:09:29
    if this patient was hooked up to suction
  • 00:09:32
    because you can also add this to suction
  • 00:09:34
    this type of ng tube you would want to
  • 00:09:36
    wait at least 30 minutes to an hour
  • 00:09:38
    before you hook that up to suction
  • 00:09:40
    because otherwise it'll just suck all
  • 00:09:41
    that food that you just gave
  • 00:09:43
    so once i'm done with that
  • 00:09:45
    i'm gonna again ask the patient if
  • 00:09:46
    they're having any cramping or feeling
  • 00:09:48
    bloating
  • 00:09:50
    and document that i administered the
  • 00:09:52
    tube feeding how much was administered
  • 00:09:55
    what type
  • 00:09:56
    make sure that that's all documented
  • 00:09:57
    correctly
  • 00:09:59
    i'm going to ask the patient if they
  • 00:10:00
    have any questions
  • 00:10:01
    and i'm going to lock and lower the bed
  • 00:10:04
    i'm going to put the alarms on if needed
  • 00:10:06
    and i'm going to put the call light by
  • 00:10:08
    the patient and the tray table and then
  • 00:10:10
    that concludes the
  • 00:10:11
    two feeding by gravity
  • 00:10:29
    you
Tags
  • alimentation entérale
  • sonde naso-gastrique
  • évaluation gastro-intestinale
  • procédure médicale
  • rinçage de sonde
  • politique d'établissement