Problem 38 - Calculate With Confidence

Question

Prepare the following solutions from the nutritional formulas. A client has an order for Jevity \(1,200 \mathrm{~mL}\) by continuous feeding through a gastrostomy tube over 16 hours, followed by \(250 \mathrm{~mL}\) of free water. The feeding is placed on an infusion pump. Calculate the \(\mathrm{mL}\) per hr to set the pump at.

Step-by-Step Solution

Answer

Set the pump to 75 mL/hour for 16 hours.

Step 1: Determine Total Volume for the Feeding

The client needs a total of 1,200 mL of Jevity. We need to calculate the flow rate to deliver this over 16 hours. Note, the 250 mL of free water is administered separately after the Jevity feed.

Step 2: Divide Total Volume by Time

Divide the total volume of Jevity, 1,200 mL, by the total time of feeding, which is 16 hours. This will give us the flow rate in mL per hour. \[\text{Flow rate} = \frac{1,200 \text{ mL}}{16 \text{ hours}} \]

Step 3: Calculate the Flow Rate

Now, perform the division: \[\text{Flow rate} = \frac{1,200}{16} = 75 \text{ mL per hour}\] Therefore, the infusion pump should be set at 75 mL per hour.

Key Concepts

Infusion Pump Calculation

Calculating an infusion pump rate is a vital skill in clinical settings. This procedure ensures the patient receives the prescribed amount of nutrition or medication over a specified time. To calculate the flow rate for an infusion pump, you need to know:

• Total volume to be infused
• Total infusion time

For this problem, the ordered volume was 1,200 mL of Jevity to be delivered over 16 hours. To find the infusion rate, divide the total volume by the time:\[\text{Flow rate} = \frac{1,200 \text{ mL}}{16 \text{ hours}} = 75 \text{ mL per hour}\]After calculating, you find you should set the infusion pump to 75 mL per hour. Always double-check the calculations to ensure accuracy and patient safety.

Feeding Tube Administration

Feeding tube administration involves supplying nutrition directly into the stomach, small intestine, or gastrostomy tube. This can be done via continuous feedings, like in the exercise, or through bolus feedings. There are essential considerations:

• Ensure the right formula is used, such as Jevity in this case.
• Confirm the tube is correctly positioned to prevent complications.
• Measure and record the residual volume if required by facility protocol.

Continuous feeding is often implemented using an infusion pump, providing a steady supply of nutrition. It's crucial to monitor the client closely for signs of discomfort or complications, such as aspiration or intolerance to the feeding formula.

Clinical Nutrition Formulas

Clinical nutrition formulas are designed to provide complete nutrition to individuals who cannot consume food normally. They often contain essential nutrients, calories, and proteins, tailored for the specific needs of a patient. Jevity, mentioned in the exercise, is an example of such a formula. It offers:

• Complete, balanced nutrition designed for long-term feeding including proteins, carbs, fats, vitamins, and minerals.
• Consistency to reduce the risk of blockages in feeding tubes.
• Fiber to maintain healthy bowel function.

When selecting a clinical nutrition formula, the patient's specific health needs and nutritional goals must be considered. Tailoring the volume and rate to meet these needs is essential for optimal patient outcomes.