PEG FEEDING

PURPOSE: Percutaneous endoscopic gastrostomy (PEG) an endoscopic medical

procedure in which a tube (PEG tube) is passed into a patient's stomach through the
abdominal wall, most commonly to provide a means of feeding when oral intake is not
adequate. This provides enteral nutrition (making use of the natural digestion process of
the gastrointestinal tract) despite bypassing the mouth; enteral nutrition is generally
preferable to parenteral nutrition
EQUIMENT:
Correct amount of feeding solution
60 ml catheter-tip syringe
Emesis basin
Clean gloves
pH strip or meter
Large syringe or calibrated plastic feeding bag with label and tubing
Measuring container from which to pour the feeding
Water at room temperature (60 ml or less)
Feeding pump as required

Procedure:

PROCEDURE
1. Assess:
For any clinical signs of malnutrition or
dehydration
For allergies to any food in the feedings
For the presence of bowel sounds.
2. Determine:
Type, amount, and frequency of feedings
Tolerance of previous feedings
3. Assemble equipment and supplies
4. Assist client to a fowlers position in bed, or a
sitting position in a chair.
5. Introduce yourself and verify the clients identity
and explain the procedure.
6. Perform hand hygiene and other appropriate
infection control procedure.
7. Provide client privacy
8. Assess tube placement.
Attach the syringe to the open end of the tube and
aspirate. Check the pH
9. If the tube was placed in the stomach, aspirate
all contents and measure the amount before
administering the feeding.
10. If the client is on the continuous feeding, check
the gastric residual
11. Administer the feeding
ROTIONALE
Your need to assess the patient to
identify any possible problems or
complication may occur.
To determine what type of feeding is
appropriate for the patient need.
For organize work place and easy
access of the equipment you will be
needed.
For the relaxing of the abdominal
muscle and allowing for improve
breathing.
This is a patient right to know all the
procedure that will be doing into her/his
body. To achieved trust between the
patient and nurse.
To prevent spread of microorganism.
To give respect to the patient and
confidentiality
Allow 1 hour to elapse before testing
If 100ml is withdraw, check with the
nurse in charge or refer to agency
policy before proceeding.
every 4-6 hours or according to
protocol.
Check the expiration date

Feeding Bag (Open System)
12. Hang the labeled bag from an infusion pole.
Clamp the tubing, and add the formula to the
bag, open the clamp and run the formula
through the tubing than reclamp.
Attach the bag to the feeding tube, and regulate
the drip.
Syringe (Open System)
13. Remove the plunger from the syringe and
connect the syringe to a pinched or clamped
nasogastric tube.
Add the feeding to the syringe barrel
Permit the feeding to flow in slowly at the
prescribed rate.
Prefilled Bottle with Drip Chamber (Closed System)
14. Remove the screw-on cap from the container,
and attach the administered set with the drip
chamber and tubing.
Close the clamp, hang the container on a
intravenous pole
Squeeze the drip chamber, opening the tubing
clamp and run the formula through the tubing
and reclamp.
Attach the feeding set tubing to the feeding tube
and regulate the drip rate.
If another bottle is not to be hung immediately, flush the
feeding tube immediately.
15. Instill 50- 60 ml of water through the feeding
tube or medication port.
Add water before the feeding solution has
drained
16. Clamp the feeding tube
17. Ensure client comfort and safety
18. Dispose of equipment appropriately
19. Document all relevant information
Warm the feeding to room
temperature
About 30 cm (12 inches) above
the tubes point of insertion into
the client
Adjusting the clamp to the drop
factor on the bag, if not placed
on a pump.
To deliver the feeding over the
desired length of time or attach
to a feeding pump
Raise or lower the syringe to adjust the
flow as needed. Pinch or clamp the
tubing to stop the flow for a minute, if
the client experiences discomfort
Squeeze the drip chamber to
1/3 to capacity
about 30 cm (12 inches)
To deliver the feeding over the
desired length of time or attach
to a feeding pump
Drained from neck of a syringe or from
the tubing of an administration port.
Clamp the feeding tube before all of
the water is instilled.
Secure the tubing to the client
gown
Ask the client to remain sitting
upright in fowlers position or in
a slightly elevated right lateral
position for at least 30 mins.
If the equipment is to be reused,
wash it thoroughly with soap
and water
Change equipment every 24
hours
Document the amount, kind of
solution taken , duration, and
assessment of the client.

20. Monitor the client for possible complications
Record the volume of feeding
and water administered on the
clients input and output record.
Carefully assess client receiving
tube feeding for problems.

MILAGROS J. NUEZ RN, MAN ALYZZA MAE L. DAGOY

CLINICAL INTRUCTION STUDENT NAME