Hey everyone, it's Sarah with RegisteredNurseAriane.com and in this video I'm going to go over how to solve tube feeding calculations. And as always whenever you get done watching this YouTube video, you can access the free quiz that will give you more practice on these calculations. So let's get started.
In this calculations video, we're going to solve different types of tube feeding problems you may encounter on your exam. So I'm going to walk you step by step how to solve problems that require you to figure out how much water is needed to dilute the feeding formula along with how to calculate that total volume that you're going to have to administer to the patient and how much time it will take for that tube feeding to be administered. Now as I do that we're going to be using a specific formula to help us to do that. Plus, I'm going to be using some dimensional analysis to help us solve for some of these answers. So if you're not familiar with dimensional analysis, I really recommend that you check out the other videos in this dosage and calculation series.
So what is a tube feeding? Well it's just as the name says. It's a tube that is going to deliver nutrition to your patient because they need some help getting some nutrition.
And this can be done various ways. One way is through a nasogastric tube. Hence we call it naso because it's going to go up through the nose. And a type of nasogastric tube is like a Dobhoff tube. So it goes up through the nose down through the throat and then it sets in the stomach and we can deliver for to that patient.
Also it can be administered through a PEG tube and this is a tube where a surgical incision has been made through the skin and a tube enters into the stomach through that route. So to help us solve some of these problems we need to remember this certain formula. So I really recommend you commit this formula to memory and how you set it up it will be milliliters formula can over X equals the strength ordered.
So now let's look at our first problem and it says the patient is ordered Jevity 1.2 Cal. You're supplied with a can of Jevity that contains 237 milliliters of formula. The doctor orders the tube feeding to be administered at half strength at a rate of 60 milliliters per hour. What is the total volume of formula that will be administered? So the very first thing what you want to do is you want to look at what the problem is asking you and this problem is specific asking for the total volume of formula that will be administered.
So you need to look in your problem see what you need to pull out of that problem to do your calculation. And remember a lot of problems are going to give you information that you really don't need. They're called distractors. So what's important in this scenario is the amount of formula that's in that Jevity can which is 237 milliliters and the strength that the doctor has ordered.
We're not really concerned about the 60 milliliters per hour to help us calculate that total volume formula. So that's really our distractor. So since we already know what we're solving for and the information we need to solve that, we're ready to use that formula.
So we're going to set our formula up with milliliters in the can. It told us that there was 237 milliliters in that can of Jevity and we're going to put that over X And then we have the strength and it told us it was half a strength. So we're going to put that like that.
Now we are ready to solve. So to solve, we're going to multiply everything across from each other. So 237 times 2 is 474. So we have milliliters. And x times 1 is 1x.
Now we have to finish solving. So... we need to get rid of this one because we're solving for x.
So we're going to divide by one that cancels out one. We're going to also do that over here on this side and then whenever we calculate that out we get 474 milliliters equals x and this is our total volume. So 474 milliliters is the total volume that's going to be administered to this patient. Now Now let's look at our next problem.
It says the patient has ordered Jevity 1.2 Cal. You're supplied with a can of Jevity that contains 237 mL of formula. The doctor orders the tube feeding to be administered at half strength at a rate of 60 mL per hour. How much water will you add to dilute the tube feeding formula as prescribed? So this problem is wanting to know how much water we're going to add to that tube feeding formula to meet the specifications that the doctor has ordered.
So that is very important to know. Now what other information do we need to know in this scenario to help us solve for that? Well we need to know how much this can contains in it, which it contains 237 milliliters, and what the ordered strength is, which is half strength.
So since we already know what we're solving for, we're ready to set up our formulas. So we're going to use this formula. Our can contains 237 milliliters. And we're solving for X.
And we're going to put the strength over here. It's half strength. So we're going to multiply everything across from each other. So 237 times 2 is 474. We get 474 milliliters.
And then X times 1 is 1X. Now we need to get rid of that 1. So we're going to divide everything. What we do on this side we have to do over here.
Whenever you solve that out, you get 474 milliliters equals X. Now, this is the total volume, but our problem is not asking for the total volume. We need to know the amount of water. Well, how are we going to do that? How are we going to figure that out?
Well, since we already know that our can contains 237 mLs, we know that our total volume is going to be 474 mLs. So what we're going to do is we're going to subtract 474 from the volume in the can. So it's 237. So 474 minus 237 equals 237 mLs.
So And this is milliliters of water that's going to be added to that feeding formula to dilute it based on what the physician ordered. Now let's look at our next problem. It says the patient is ordered glucerna 1.5 cal.
You're supplied with a can of glucerna that contains 237 mLs of formula. The doctor orders the tube feeding to be administered at one fourth strength at a rate of 50 mLs per hour. How much water will you add? to dilute the tube feeding formula as prescribed.
So again we need to ask ourselves what are we solving for? Well this problem wants to know how much water we're going to add to that feeding formula to dilute it. So what important information do we need to pull out of this scenario?
Well we need to know how much is in a can of glucerna that we're supplied with and it's 237 mLs and we need to know that strength and it's 1 4th strength. Now distractor is that rate of 50 mLs per hour. We're not really concerned with that.
It's important, but it's not what we need to solve this problem. So we pulled from that scenario what we need to solve this problem. So now we're ready to plug into our formula. So we're going to put how much milliliters was in that glucerne I can, and it told us there was 237 milliliters.
and we're solving for X because remember that helps us solve for our total volume. And then we have this strength and the strength is one fourth. So let's figure out our total volume.
Then once we figure out total volume, we can subtract that amount from how much is originally in this can. And then we get the amount of water we need. So we're going to multiply everything across from each other.
So 237 times four is 948. So we get 948 milliliters. And then X times one equals one X. And then we need to get rid of that one.
So we're going to divide everything that cancels that out over there, leaving us just with X. Then we, what we did over here on this side, we got to do over here. So when you work that out and divide that, you get 948 mLs equals X, which is our total volume. But our question doesn't want to know total volume.
It wants to know the amount of water we need to dilute this feeding formula. So we're going to take 948 and subtract it from 237 milliliters. And we get 711 milliliters of water that we're going to need to dilute this tube feeding formula to meet the parameters that the physician has given us.
Now let's look at our next problem. It says the MD orders glucerna via the patient's nasogastric tube. The formula is to be administered at 3-4 strength. at a rate of 60 mLs per hour.
You're supplied with a can of glucerna that contains 237 mLs. How long will it take to administer this tube feeding formula? So this problem wants to know how long it's going to take to administer this specific tube feeding formula.
So first, what we're gonna have to do is calculate the total volume and again the total volume is the amount that is in that two feeding formula can plus if we have to dilute it with water so that's our total volume so we need to know what we're supplied with so the can of glucerna and it tells us it's a 237 ml can and then we need to know the strength of how this two feeding is going to be administered so we need to do a three-fourth strength so those two things are very important now When we solve for that, we're going to have to go and we're going to have to look at the rate, how this physician wants this to be administered to this patient. And it tells us that we need to give it at a rate of 60 mLs per hour. So based on everything we pulled out of that scenario, we know that this is going to be a two-step problem because first we have to solve for that total volume. And this is where this formula is going to come in handy.
Then we're going to take that answer and then we're going to apply it to the rate and see how long it's going to take to administer that amount based on this rate the physician ordered. So let's start with our formula first. So milliliters in can, it was 237 milliliters.
And we're solving for the total volume, so that's over x. And the strength is 3 fourths, so we're going to put that over here. And we're going to multiply everything across from each other.
So 237 times 4 is... 948 milliliters and then X times 3 is 3 X now we've got to get rid of that 3 because we want to solve for X so we're going to divide cancels that out. What we did over here, we have to do over here. So 948 divided by three is 316 mLs.
And that equals our total volume. So that's the total amount that's going to be given to that patient. That includes the formula amount that's in that can plus that water we added to it to equal that three-fourth strength. Now let's solve for infusion time. So what we're going to do is...
we're going to take our total volume and this is where we're setting up with like dimensional analysis so we're going to do 316 mls over 1 times our rate that's where our rate comes in handy so it's 60 mls so 60 mls per hour okay mls cancels out figuring out our time so 316 times 1 is 316 and then 1 times 60 is 60 so 316 divided by 60 is 5.2666 repeating and I'm going to round to 5.27 always round how your program wants you to round so this tells us that we have 5.27 hours well we've got to take that a step further we know it's going to take us five hours but this 0.27 is in hours we need to really convert this to minutes so I'm going to go ahead and write five hours right here I need to convert this leftover hours to minutes let's figure that out so we're going to take 0.27 because that's our leftover from the hours and that's hours over 1 times we know that one hour equals 60 minutes so we're converting that to minutes hours cancels out and 0.27 times 60 is 16.2 minutes so we're going to round to our nearest whole number so it's going to be 16 minutes so our answer is that it's going to take five hours and six minutes to infuse this total volume based on this rate that the physician ordered. Okay so that wraps up this video on how to solve for tube feeding calculations and don't forget to access the free quiz that will give you more practice and to check out the other videos in this dosage and calculation series.