>> Kathie Kushto-Reese: Hi. My name is Kathie Kushto-Reese.

>> Shari Lynn: And I'm Shari Lynn.

>> Kathie Kushto-Reese: And today we're going to talk about nasogastric tube feeding, both bolus and NG pump feeding.

>> Shari Lynn: Bolus tube feed procedure. Check doctor's orders. Wipe. Obtain ordered amount of feeding. Sit patient up to at least a 30 to 45 degree angle. Don clean gloves. Tube position may be checked by PH, aspiration of gastric contents or injection of air, according to institutional protocol. Aspirate and check for residual. Return residual to stomach. Disconnect syringe and remove plunger. Attach empty barrel of syringe to tube. Hold syringe 6 to 12 inches above stomach and begin to pour in fluid. Allow fluid to run in by gravity. As tube feeding nears base of syringe, add more feeding to avoid air entering in to the stomach. At end of feeding, add 30 to 50 milliliters of sterile water to flush tube according to order. Allow water to run in. Then close stopcock and pin tube to gown. Keep patient in upright position at least 60 minutes after tube feed. Wash hands. And document.

>> Kathie Kushto-Reese: Administration of continuous tube feeding by a pump. Check doctor's orders. Wipe. Set patient up to at least 30 to 45 degree angle. Don clean gloves. Tube feeding position can be checked by PH, aspiration of gastric contents and/or injection of air. Refer to institutional protocol. Measure ordered amount. Fill feeding bag with 4 to 8 hours worth of tube feeding. Turn on pump. Push auto prime button and prime tubing. Connect tubing to patient. Set CCs per hour and volume to be infused on feeding pump, and begin feed. After 4 hours, pause the feeding pump and check residual. If the amount is 1.5 to 2 times the greater the hourly rate, reinstall and hold for 1 hour. Recheck the residual remains. Hold and notify MD. Flush with sterile water per order. And then restart pump if residual is within normal limits of hospital protocol. Remove gloves. Wash hands. And document.