Enteral Nutrition
Nutrition delivered through the GI tract via feeding tube
Definition
Enteral nutrition (EN) is the delivery of nutritionally complete liquid formula directly into the GI tract through a tube. It maintains gut integrity and is preferred over parenteral nutrition when the GI tract is functional.
Types of Feeding Tubes
- NG (nasogastric): Short-term (less than 4 weeks)
- NJ/ND (nasojejunal/duodenal): For aspiration risk or gastric dysfunction
- PEG (percutaneous endoscopic gastrostomy): Long-term
- J-tube (jejunostomy): Long-term, post-pyloric
Administration Methods
Continuous (preferred for critically ill), intermittent bolus, cyclic (nighttime only).
Nursing Considerations
- Verify placement (X-ray initially; pH less than 5 and aspirate for reverification)
- Elevate HOB 30 to 45° during and 60 minutes after feeding
- Check gastric residual per protocol (hold for >500 mL or per order)
- Flush with 30 mL water before/after feedings and meds
- Monitor for aspiration, diarrhea, refeeding syndrome (in malnourished patients)
- Daily weights, I&O, electrolytes, glucose
NCLEX Relevance
HOB elevation and placement verification are top aspiration prevention topics.