Don’ts Feeding Regimen • Use rubbing alcohol or hydrogen peroxide daily to Formula: ______clean your tube feeding site □ (Okay for equivalent formula) Total: ______cans (each can is ______ml) • Leave your stoma/dressings wet
• GETTING TO Use pool or tubs Delivery Site: Gastric via PEG tube • Crush sustained release medication KNOW YOUR Method of administration:
□ Pump Assisted PEG TUBE Start at ______ml/hr
Tube Feeding Success: It takes a Team Advance by ______ml/hr every _____ hr to goal rate of ______ml/hr The Doctor: Phone: ______- Order and clear you for PEG placement □ Gravity Assisted/ Bolus (Syringe) Initial _____ml bolus over _____ min ______times daily The Home Nurse: Advance by ______ml each day to a goal of _____ ml Phone: ______feeding over _____ min ______times daily - Instruct you on how to use your feeding tube and care for your PEG tube Water Flushes: □ Flush the feeding tube with ______ml of clean water The Social Worker: before and after each meal Phone: ______- Help coordinate your formula and supplies □ Flush the tube with an additional ______ml of clean needs for tube feeding water ______times daily. - Help you with future deliveries Other: The Dietitian: □ Maintain head elevated at least 30-45 degrees during Phone: ______feeding (for gravity assisted/ bolus- maintain head of bed - Prescribe a formula and a tube-feeding elevated for 30-45 minutes before and after each feeding). regimen that will help you get all the nutrition If you can sit upright, then do so. you need What is a PEG tube? □ An opened container can stay at room temperature no The Speech Therapist: more than 4 hours if sealed properly. Use or discard Phone: ______remaining of the product. - Evaluate your ability to swallow and Percutaneous Endoscopic Gastrostomy (PEG)
recommend a diet consistency Feeding Tube □ Store open containers of formula in the refrigerator for a A PEG tube is a type of feeding tube that the tip goes maximum of 24-48 hours, and bring formula to room Work with you to help rehabilitate your swallowing directly to your stomach temperature before infusing it. ______
Formula Bag (for some patients) some (for Bag Formula
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