A neonate is being fed 20 mL every three hours by orogastric lavage. At the beginning of this feeding, the nurse aspirates 15 mL of gastric residual. Which of the following would be the most appropriate action by the nurse?

Question

1. Withhold the feeding and notify the physician.
2. Replace the residual and continue with the full feeding.
3. Replace the residual, but only give 5 mL of the feeding.
4. Withhold the feeding and check the residual in three hours.

Answer 1

1
Rationale:
1. Residual of more than half the amount of feeding indicates delayed emptying, and could be a sign of necrotizing enterocolitis. Early detection of enterocolitis is essential, and aggressive management is required. Therefore, the physician should be notified of this finding.
2. The amount of residual is too much to replace and continue with the feeding.
3. The amount of residual is too much to replace and continue with the feeding.
4. Waiting for three hours to recheck the residual could delay treatment of a serious condition.
Nursing Process: Evaluation
Client Need: Physiological Integrity