POSSIBLE SOLUTIONS

Reassure the patient, provide additional instructions and psychological help based on their needs

POSSIBLE SOLUTIONS

Evaluate medications, consult pharmacist³

POSSIBLE SOLUTIONS

Discontinue tube feeding until medical evaluation³

POSSIBLE SOLUTIONS

Check for proper placement (e.g., nasogastric tube has not migrated into small bowel)
Consider post-pyloric feeding below the Treitz ligament^1,2
Note: attention to oral hygiene is important with enteral nutrition as microbial contaminations and alteration of microbiota in the oral cavity have been associated with aspiration pneumonia¹⁰

POSSIBLE SOLUTIONS

Consider closed system feedings; consider antiemetic agent if appropriate³

POSSIBLE SOLUTIONS

Elevate the headboard to 30-45 degrees during continuous feeding unless contraindicated; for intermittent feeding, elevate the headboard to the upright position during feeding and at least 30 minutes after^2,3

POSSIBLE SOLUTIONS

Assess abdomen, review medical history for any underlying motility disorders, consider prokinetic medications, monitor glucose control if relevant³; consider a whey-based formula^7-9

POSSIBLE SOLUTIONS

Review feeding regime, reduce rate/volume or adjust feeding schedule as needed, use room temperature formula³

POSSIBLE SOLUTIONS

Assess abdomen; disimpact as needed using enemas; monitor stool frequency and consistency³

POSSIBLE SOLUTIONS

Consider a whey-based formula to facilitate gastric emptying^7-9; consider a lower fat, lower osmolarity and neutral pH formula