Nutrition Interventions for Children with Special Health Care Needs

Appendix N
Complication Possible Cause Intervention
• Use correct formula
• Flush tubes with water after giving formula or medication
• Flush every 3-4 hours with continuous drip feeds
• Do not mix formula with medication
• Irrigate with air, using syringe
• Gently “milk” tubing
• Dissolve ¼ tsp. meat tenderizer in 10 cc water and flush to dissolve clot
• Replace tube
Clogged feeding tube • Formula residue or
coagulated protein
• Inadequate flushing
of tube
• Medication
• Place child upright for feeding
• Make sure gastrostomy tube is firmly in place
• Stabilize tube with gauze pads, adjust crosspiece
• If stoma is too large for tube, insert new tube
• Keep skin around stoma clean and dry; use protective ointments and gauze
• If leaking out of button gastrostomy, may need to replace device
• Refer to physician
• Improper positioning
• Tube migration
• Increased size of
stoma
Leakage of gastric
contents
• A small amount of bleeding is normal
• Tape tube securely in place to avoid irritation from movement
• Secure tube under child’s clothing
• Refer to physician
• Excessive movement
or pressure on tubing
Bleeding around
stoma
• Correct cause of leakage
• Carefully cleanse and protect stoma
• If stoma site is irritated, use plain water or change soap used
• Refer to physician for culture and medication
Infection of stoma • Gastric leakage
around tube
• Stoma site not kept
clean
• Allergic reaction to
soap
• Keep area clean and dry
• Adjust snugness of PEG tube with crosspiece
• Stabilize tube using tape, bandnet, ace bandage, tube top
• Prevent child from pulling on tube
• Apply silver nitrate as directed by physician
Granulation tissue • Body rejecting foreign
body
• Poorly fitting tube
causing friction
• Use of antiseizure
medication such as
Dilantin
366 Nutrition Interventions for Children With Special Health Care Needs
* See Chapter 6.