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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

 

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.

 

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