Potential Complications
There are several categories
and types of complications. We will discuss selected
complications from tube-related problems and symptoms or
metabolic changes that can occur related to tube
feeding. There are a number of items that the patient
and caregiver can troubleshoot and minor problems that
can be resolved by the patient or caregiver. However,
there are a number of potential problems and
complications that require professional intervention by
the health care professional, and it will be important
to provide the patient and/or caregiver with education
and training on all of these issues.
•Categories
–Tube
issues:
•Displacement,
blockage, tube leakage, infection
•Aspiration
•Pump
failure
–Symptoms
and metabolic changes:
•Nausea,
vomiting, diarrhea, constipation, skin irritation
•GI
bleeding, hyper/hypoglycemia, fluid/electrolyte
imbalances
Let's take a look at some examples of patient checklists
for solving minor problems and seeking medical
attention. There may be more patient-specific
information that should be covered in patient/caregiver
training sessions related to diseases or other
conditions that may not be included here.
After the patient checklists, we will go through some
additional complications that should be monitored and
resolved with the physician and nutrition team.
Calling the Doctor
–Redness
or rash, increased drainage or bleeding, bad
smell around stoma
–High
temperature
–Ongoing
upset stomach, vomiting, gas, diarrhea,
coughing
–Constipation
–Increasing
abdomen size
–Continued
high
residuals or blood
–Tube
is pulled out,
broken or cut
–Tube
is clogged,
too long or short
–Any
problems breathing
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The patient should be given a list
of items that warrant contacting the physician so that
timely medical care can be delivered. For instance,
while care can be taken to prevent skin irritation or
other complications, leaking tubes and skin irritation
or rash can indicate the need to look for a poorly
fitting tube, excessive tube pulling, or mechanical tube
problems. These can all be solved by altering the
prescribed equipment and methods. High temperatures can
indicate the need to check for infection and
contamination of the tube and tube feeding. Other
symptoms can be intermittently handled, as we will see
in following slides. However, persistent problems should
be reported and may require prescriptive changes in
formula, methods, and equipment.
If there are any problems with breathing, it should be
immediately reported. This can be related to aspiration
(as well as other problems) that may require urgent
medical intervention.