Ch. 14 - Feeding Tubes

Front 1

Whenever possible, nutrition should be provided to ill and injured patients by what route of feeding?

Back 1

Enteral

(through the mouth / GI tract)

Front 2

Selection of route, feeding tube, and diet depend on what 3 things?

Back 2

1. patient's level of consciousness

2. patient's diagnosis

3. status of the GI tract

Front 3

Name the 3 types of tubes that can be placed by a vet tech:

Back 3

1. nasogastric

2. orogastric

3. nasoesophageal

Front 4

OG TUBE (Orogastric Tube)

1. Placement is via mouth to the ___________ or the _________.

2. Is tube removed / how often?

Back 4

1. esophagus, stomach

2. yes - after each feeding

Front 5

OG TUBE (Orogastric Tube)

Advantages: (3)

Back 5

1. good for short-term, assisted feeding

2. neonates tolerate well (better than adults)

3. rapid - delivers high quantities of food quickly

Front 6

OG TUBE (Orogastric Tube)

Disadvantages: (4)

Back 6

1. patient tolerance varies

2. risk of aspiration

3. stressful - requires firm restraint

4. patients often only tolerate for short time (1-2 days)

Front 7

OG TUBE (Orogastric Tube)

Contraindications: (3)

Back 7

1. patients with injury to:

• oral cavity
• larynx
• pharynx
• esophagus

2. patients with altered LOC

3. patients with abnormal swallowing/gag reflex

Front 8

OG TUBE (Orogastric Tube)

Tube care:

Back 8

Rinse well after each use

Front 9

NE / NG TUBE

(Nasoesophageal / Nasogastric Tube)

1. Placement:

2. NE goes via ________ to __________ ___________.

3. NG goes via _________ to ___________.

Back 9

1. doctor's choice

2. nares / lower esophagus

3. nares / stomach

Front 10

NE / NG TUBE

(Nasoesophageal / Nasogastric Tube)

Which tube (NE / NG) has a lower risk of vomiting, reflux, and aspiration pneumonia?

Back 10

NE (Nasoesophageal)

Front 11

NE / NG TUBE

(Nasoesophageal / Nasogastric Tube)

Advantages (4)

Back 11

1. Easy to place - no sedatives / no anesthesia

2. Usually well-tolerated (will need E-collar)

3. Inexpensive

4. Good for 3-14 days of feeding

Front 12

NE / NG TUBE

(Nasoesophageal / Nasogastric Tube)

Disadvantages: (3)

Back 12

1. Food choice is limited by size of tube

2. Liquid diets may cause diarrhea

3. Tubes are prone to blocking

*Rinse well after use

Front 13

NE / NG TUBE

(Nasoesophageal / Nasogastric Tube)

Contraindications: (5)

Back 13

1. head/neck injury

2. Surgery of nasal cavity, larynx, pharynx

3. patients with no normal gag reflex

4. comatose / recumbent patients

5. vomiting, GI obstruction, upper airway disease

Front 14

NE / NG TUBE

(Nasoesophageal / Nasogastric Tube)

Tube Care:

Back 14

Rinse with warm water prior to feeding.

Fill tube with water and cap after feeding.

Front 15

E TUBE

(Esophageal Tube)

1. Placement:

Back 15

Surgically placed into the caudal esophagus

Front 16

E TUBE

(Esophageal Tube)

Advantages: (6)

Back 16

1. can use gruel-type diet

2. easy placement

3. owner can do at home

4. long-term feeding

5. patient can eat/drink on its own

6. useful in cats with hepatic lipidosis

Front 17

E TUBE

(Esophageal Tube)

Disadvantages (3)

Back 17

1. requires anesthesia

2. feeding must wait until 24 hours after placement

3. tube must remain in place 7-10 days

Front 18

Why must E Tubes stay in place 7-10 days minimum?

Back 18

So stomach contents do not leak into the abdominal cavity.

Front 19

E TUBE

(Esophageal Tube)

Contraindications: (2)

Back 19

1. esophageal disorder

2. History of esophageal surgery

Front 20

E TUBE

(Esophageal Tube)

Care: (4)

Back 20

1. Flush with warm water before and after feeding

2. place water in tube and cap after feeding

3. change bandage around surgical site daily

4. clean periodically with antiseptic solution

Front 21

PEG TUBE

(Gastrostomy Tube)

(Percutaneous Endoscopic Gastrostomy)

1. Placement:

Back 21

1. Surgically placed directly into the stomach endoscopically

Front 22

PEG TUBE

(Gastrostomy Tube)

(Percutaneous Endoscopic Gastrostomy)

Advantages: (6)

Back 22

1. long-term nutritional support

2. ideal for patients with injury to oral cavity, esophagus, etc.

3. patient can eat/drink on its own

4. gruel-type diet okay

5. owner can do at home

6. hepatic lipidosis cats

Front 23

PEG TUBE

(Gastrostomy Tube)

(Percutaneous Endoscopic Gastrostomy)

Contraindications: (6)

Back 23

1. gastric disease

• ulcers
• neoplasia

• vomiting
• pancreatic disease
• related surgery

Front 24

PEG TUBE

(Gastrostomy Tube)

(Percutaneous Endoscopic Gastrostomy)

Care: (5)

Back 24

1. Flush tube with warm water before and after feeding

2. Place water in tube after feeding and cap

3. change bandage often

4. clean area

5. tube must be monitored for migration (by vet)

Front 25

Jejunostomy Tube:

Placement:

Back 25

directly into Small Intestine (Surgically)

Front 26

Jejunostomy Tube:

Advantages: (4)

Back 26

1. okay for patients in which stomach or duodenum must be passed

2. can provide nutrients while stomach remains empty

3. feeding can begin immediately

4. can decrease recovery time from upper GI disease / surgery

Front 27

Jejunostomy Tube:

Contraindications: (3)

Back 27

1. persistent diarrhea

2. intestinal obstruction distal to tube

3. Ileus: obstruction of intestine due to it being paralyzed (gut stasis)

Front 28

Jejunostomy Tube:

Care: (5)

Back 28

1. Flush with warm water before and after feeding

2. leave water in tube after feeding and cap

3. change bandage often

4. clean area

5 tube must be monitored for migration