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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Nutrition

Enteral Nutrition: Jejunostomy Tube Feeding (296)

Enteral Nutrition: Jejunostomy Tube Feeding (296) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition

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Jejunostomy Tube Feeding

A jejunostomy tube (j-tube) enters through your abdomen into your small intestine. This tube is used for tube
feeding formula, water, and medicine (instead of taking them by mouth). Tube feeding formula is a liquid
source of nutrition that provides calories, protein, water, vitamins and minerals. Your tube feeding formula will
be given through a feeding pump. Tube feedings are started in the hospital and require follow-up with a
registered dietitian after discharge.

My Tube Feed and Hydration Plan




































Tube Feeding Formula
______________________________________________________________________________

Amount of Tube Feed Formula Needed Daily
You need a total of _____ cans or _____ ounces or _____ milliliters (mL) per day

Tube Feed Schedule
For continuous tube feeds, set your pump to a rate of ______ mL per hour.

For cycled tube feeds, follow the schedule below. A cycled tube feed shortens the time of a feeding by increasing
the rate. Increase every _____ days or as instructed by your healthcare provider.
______ mL per hour for _____ hours
______ mL per hour for _____ hours
______ mL per hour for _____ hours

Additional Water Flushes Needed
You need a total of ________ mL of water per day to stay hydrated (equal to ____ fluid ounces and ____ cups)

Your goal tube feeds provide ________ mL of water per day

In addition to goal tube feeds, you need ______ mL of water per day (equal to ____ fluid ounces and ____ cups)

Water Flush Schedule
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________


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Continuous or Cycled Tube Feeds by Pump
1. Wash your hands with soap and water. Dry them with a clean towel.
2. Use room temperature formula. Very cold formula may cause stomach discomfort.
3. Preparing the feeding: You will either use a ready-made formula or one that requires at home preparation
from powder.
A. Ready-made:
ξ If using a ready-made formula, wash the lid of the can and dry the lid with a clean towel
ξ Only open containers of formula that you will need for the feeding
ξ Shake the can(s) before opening
ξ Only place 8 hours’ worth of formula into the bag
ξ Leftover formula that is open can be stored in the refrigerator with a cover
ξ Discard formula that has been open for more than 24 hours
B. Prepared formulas from powder:
ξ Follow the mixing instructions for preparation given by your healthcare provider
ξ Only place 4 hours’ worth of formula into the bag
ξ Leftover formula that is open can be stored in the refrigerator with a cover
ξ Discard formula that has been prepared more than 24 hours ago.
4. Pour the formula into the feeding bag.
5. Open the cap on the feeding tube and using a syringe, insert at least 30 mL of warm water into your tube
or as instructed by your healthcare provider.
6. Remove the syringe and put the tubing from the pump into your feeding tube. Start the pump at the
prescribed rate.
7. Keep your head elevated at least 30 degrees while you receive a feeding.
8. To prevent clogging, flush the tube with 30 mL water every 4 hours while the tube feeding is running or as
instructed by your healthcare provider.
9. When the feeding is complete, disconnect the bag. Flush your feeding tube with 30 mL of warm water or
as instructed by your healthcare provider and cap the tube to prevent leaking.
10. Rinse the feeding bag and tubing with water and then swish with warm water and a small amount of liquid
dishwashing detergent. Rinse and allow to air dry. Change out the tube feeding bag every 3 days.
11. Clean the syringe with warm, soapy water and allow to air dry completely between feedings. Change the
syringe each week.
12. To allow you more freedom, there are special backpacks you can get for feeding pumps. Check with your
medical supplier about this option.

Water Flushes
Your body needs enough fluid to stay hydrated. The tube feed formula will provide some fluids. The rest of
your fluid will be met by oral intake (if safe) and/or by doing water flushes through your feeding tube. You
may not be getting enough fluid if you have: dizziness, dry mouth, dry lips, lower urine output than normal and
dark urine.

Medicine
You can give medicine through the feeding tube if you are unable to swallow them. Follow these instructions:
1. Do not add medicine directly to the formula
2. Give each medicine one at a time; do not mix together.
3. Flush the tube with 30 mL water before giving a medicine or as instructed by your healthcare provider. If
giving more than one medicine at one time, flush in between each dose with 10 mL water.

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4. Crush and dissolve pills in at least 30 mL water prior to flushing them through the tube. Never crush enteric-
coated or time-release capsules.
5. Flush the tube again with 30 mL water after administering the medicine. or as instructed by your healthcare
provider.

Call Your Doctor If…
ξ Your tube may clog sometimes. Medicines may cause clogs or it may clog if you are not flushing your tube
with water often enough. This is not an emergency. First try to flush the tube with 30 mL of warm water.
Never force fluid into the tube. If this does not unclog the tube, call your doctor. If your tube clogs at night
you can wait until morning to call.
ξ If your tube falls out, call your doctor right away. Although this is not harmful to you, replacing the tube
becomes more difficult the longer the tube is out.
ξ Weigh yourself 3 times a week at the same time of day on the same scale. Early morning is best, after
urinating. Keep a record of your weight. If you notice weight gain or loss of more than 2-3 pounds per
week contact your doctor, nurse or registered dietitian.
ξ Nausea or upset stomach for more than 24 hours.
ξ Diarrhea (3 or more loose, watery bowel movements) for more than 2 days.
ξ Constipation (lack of bowel movement) for more than 5 days.
ξ Anything that causes you to stop giving tube feedings for more than one day.

Teach Back
What is the name of the formula being prescribed for your tube feeds?
How many cans of formula do you need each day?
When do you need to flush your tube with water?

If you are a UW Health patient and have more questions please contact UW Health at one of the phone numbers
listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can
be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.
















Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If
this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be
used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you should talk with your
doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright © 9/2017
University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and
the Department of Nursing. HF#296