At the end of one hour, the BSN level II students

should be able to:

1. Distinguish enteral feeding from parenteral
feedings; and
2. Come up with a food plan for blenderized
formula using a particular diet prescription.
Enteral feeding
- pertains to the delivery of food and nutrients
either orally or by the tube directly into the
gastrointestinal tract (GIT).
- it is intended for patients with
functioning GIT but unable to ingest the
required nutrients orally or for pt’s. with
impaired digesting capacity or unable to
absorb nutrients.
TYPES OF ENTERAL FEEDING
1. Ready-to-use Formulation

2. Tube Feedings

3. Standard Tube Feedings

4. Blenderized Tube Feeding

1. Ready-to-use Formulation
a. Nutritionally complete formulation
b. Modular formulation
c. Combined formulation
1. Ready-to-use formulations
a. nutritionally complete formulation
- can be used alone and provides the total
needs in a specified volume of formula.
1. Ready-to-use formulations
b. modular formulation
- provides the different forms of individual
nutrients to supplement existing formulas.
1. Ready-to-use formulations
c. combined formulation
- meets the therapeutic needs
2. Tube Feedings
- this type of feeding may be prepared from
regular foods.
3. Standard Tube Feeding
- this type of feeding is fiber-free and
high in cholesterol, fat, and sugar.
- it is a milk-based formulation with
sugar and soft cooked eggs.
4. Blenderized Tube Feeding
- it consists of soft diet allowances which can
be blenderized easily.
Complications
1. Mechanical

2. Gastrointestinal

3. Metabolic
1. Mechanical
a. Nasopharyngeal irritation
- ice chips, topical anesthetic, &
decongestant
1. Mechanical
b. Luminal Obstruction
- flush; replace tube
1. Mechanical
c. Mucosal erosions
- reposition tube, ice water lavage;
remove tube
1. Mechanical
d. Tube displacement - replace tube
1. Mechanical
e. Aspiration – discontinue tube feeding
2. Gastrointestinal
a. cramping/distention – change formula,
reduce infusion rate.
2. Gastrointestinal
b. vomiting/diarrhea – dilute formula;
reduce infusion rate; anti-diarrheal
agents
2. Gastrointestinal
c. constipation – promote sufficient fluids
and fibers; encourage patient activity
3. Metabolic
a. hypertonic dehydration
- increase free water
Hypertonic dehydration occurs when there's an
imbalance of water and salt in your body.
Losing too much water while keeping too much
salt in the fluid outside your cells
causes hypertonic dehydration.
3. Metabolic
b. Glucose intolerance – reduce infusion
rate; give insulin

c. Cardiac failure – reduce

sodium content;
fluid restriction
3. Metabolic
d. renal failure – decrease phosphate,
magnesium, potassium, protein
restriction, essential amino acids solutions.
3. Metabolic
e. hepatic encephalopathy – decrease
amount of protein
¨ Nasogastric
¨ Nasoduodenal or nasojejunal
Nasojejunal
¨ Esophagostomy
- Used in patients
with head and
neck cancer
¨ Gastrostomy or Percutaneous Endoscopic
Gastrostomy (PEG)
¨ Jejunostomy or Percutaneous Endoscopic
Jejunostomy (PEJ)
Parenteral Feeding
- is designed for individuals who cannot
accept or assimilate nutrients given
enterally.

Refer to page 315 for the Calculation of

Nutritional Needs for Hypermetabolic Patients
1. Peripheral Vein Route
- this route is intended for patients
with mild to moderate
nutritional deficiency.
2. Parenteral Hyperalimentation (IVH)
- this is a long term nutritional support of 2
weeks for patients who cannot be fed
through GIT