Checklist for Skill 24. Administration of a Bolus Feeding
(NG, NJ, Gastrostomy)
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Skill 24. Administration of a Bolus
Feeding (NG, NJ, Gastrostomy)
Able to
Perform
Able to
Perform with
Assistance
Unable to
Perform
Initials
and Date
Procedure
1.
Check order for type, amount, and frequency of feeding.
Comments:
2.
Gather equipment.
Comments:
3.
Explain procedure to child and family.
Comments:
4.
Wash hands.
Comments:
5.
Warm formula to room temperature.
Comments:
6.
Position child on right side or supine with head elevated. Have
assistant hold/comfort child as necessary..
Comments:
7.
Put on nonsterile gloves.
Comments:
8.
Check placement of tube as appropriate for type of tube.
a. For nasogastric tube check placement as described earlier.
b. For a nasojejunal tube check placement by measuring length of
tube from nose to tube hub. This distance should have been
recorded in the chart at the time of verification of placement and
checked on a regular basis after verification.
c. Placement check not needed for gastrostomy tubes.
Comments:
9.
Check for residual if indicated. Attach syringe and pull back on
plunger. Note amount and character of residual.
Comments:
Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning, Inc.
Permission to reproduce for clinical use granted.
Page 1 of 2
Skill 24. Administration of a Bolus
Feeding (NG, NJ, Gastrostomy)
Able to
Perform
Able to
Perform with
Assistance
Unable to
Perform
Initials
and Date
10. Return residual to child and flush tube.
NOTE: If residual greater than 1/2 the amount of the previous feeding
notify the physician. For neonates notify physician if residual exceeds
20% of previous feeding or more than 2 cc/Kg.
Comments:
11. Attach empty syringe. Keep the tubing pinched.
Comments:
12. Flush tube. Assesses patency and flow in the tube.
a. Neonates or fluid restricted children flush with 1–2 cc water or air.
b. Other children flush with 5–10 cc of water.
Comments:
13. Add feeding to syringe and administer feeding. Control rate of feeding
by raising or lowering the syringe.
NOTE: The length of feeding should be similar to that of oral feeding, not
less than 20 minutes. May take 30–60 minutes.
NOTE: With a gastrostomy tube hold straight up from insertion site.
Comments:
14. Following administration of feeding, flush tube with water.
a. Neonate or fluid restricted children flush with 1–2 cc of water or
air. If flushing with air and feeding gets sluggish consider flushing
with water.
b. Other children flush with 10–15 cc of water.
Comments:
15. Remove syringe and rinse after each feeding. Syringe may be used for
12 hours before being discarded.
Comments:
16. Remove gloves. Wash hands.
Comments:
Documentation
1.
2.
3.
4.
5.
Check for residual.
Amount of residual.
Time of feeding.
Type and amount of formula.
How procedure tolerated.
Comments:
Copyright © 2007 Thomson Delmar Learning, a division of Thomson Learning, Inc.
Permission to reproduce for clinical use granted.
Page 2 of 2