Place the steps for starting a scheduled enteral feeding through an established gastric tube in the correct order.
Ordered Response
Choose your responses, then check the answer.
Explanation
First verify the complete order and product. Position the client and assess tolerance, then trace the line and verify that the established tube has not migrated. Flush as prescribed and connect only to the enteral port. Start at the ordered rate and continue monitoring and documentation.
Correct sequence Verify → position and assess → trace and confirm tube position → flush and connect → start and monitor.
Why this is correct A complete enteral order includes the client, formula, access route, rate or volume, and water flushes. Head-of-bed elevation reduces aspiration risk. Line tracing prevents misconnections, and a change in external tube length can indicate migration. Placement must be checked using accepted facility methods; injecting air and listening over the stomach is not a reliable confirmation method. Monitoring continues after initiation because intolerance and displacement can develop during therapy.
Scope note This sequence applies to an established tube. A newly inserted blindly placed tube requires initial placement confirmation according to facility policy before feeding.
Reference
1ASPEN Safe Practices for Enteral Nutrition TherapyOrder verification, placement checks, head-of-bed elevation, administration, and monitoring
Established adult enteral accessThe client is stable and has an existing gastric feeding tube. Initial placement was previously confirmed. Follow the prescription, manufacturer instructions, and facility placement-verification policy.
Enteral Feeding — Nutrition delivered through the gastrointestinal tract by tube.
Aspiration — Entry of gastric contents or secretions into the airway.
Tube Patency — The tube is open and able to deliver feeding or medications.