TUBE FEEDING IHP Student's Name * First Middle Last Suffix This field is required. Please complete the following fields: First,Last. PhotoAccepted file types: jpg, gif, png, jpeg, Max. file size: 100 MB.DoB Month Incorrect Value for Month field Day Incorrect Value for Month field Year Incorrect Value for Month field Please enter a valid date. GR/LevelDaycareEEPKKN010203040506070809101112Post-GraduateWould you like to add the student's ID number? Yes No ID Campus/Building Would you like to add the student's homeroom number and teacher's name? 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Yes No ContactContact Name Add RemoveRelationship Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Name RelationshipChoose one:ParentGuardianOtherContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFaxContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFax Add More Treating Physician Add RemovePhysician Phone Number Add RemovePhysician Fax Number Add RemoveTreating Physician Physician Phone Number Physician Fax Number Add More Preferred Hospital City MEDICAL DIAGNOSIS(ES)Add a medication or procedure? Yes No MEDICATIONS/PROCEDURES Medication/Procedure Strength Dose ModeChoose one:OralTopicalInhaledIntranasalSQNebulizerSublingualRectalIMIVSched/PRN?Choose OneScheduledPRNTime Frequency If PRN, administer for Medication/Procedure Add RemoveStrength Add RemoveDose Add RemoveMode Add RemoveSched/PRN? Add RemoveTime Add RemoveFrequency Add RemoveIf PRN, administer for Add Remove Add More MEDICAL HISTORYASSESSMENT NursingList InterventionList OutcomesList Nursing Diagnosis: Risk for Aspiration Related to inability to swallow or impaired swallowing mechanism due to medical condition Related to feeding tube placement or improper feeding administration Interventions The school nurse will verify tube placement before each feeding using recommended methods (e.g., checking pH level or aspirating gastric contents). The school nurse will ensure the student is in an upright position during feedings and remains upright for at least 30 minutes afterward to minimize the risk of aspiration. The school nurse will observe the student for any signs of distress such as coughing, wheezing, or choking during or after feedings. The school nurse will train school personnel on recognizing the signs of aspiration and proper responses. Expected Outcomes The student will not experience episodes of aspiration during tube feedings. School staff will demonstrate appropriate techniques for managing tube feedings and responding to potential aspiration incidents. Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements Related to insufficient intake or tolerance of tube feedings Related to inability to consume adequate nutrition through normal eating Interventions The school nurse will assess for signs of intolerance such as nausea, vomiting, bloating, or diarrhea during or after feedings. The school nurse will work with a dietitian to ensure the student’s tube feeding formula meets their nutritional needs and adjust as necessary. The school nurse will regularly track the student’s growth and weight to assess adequacy of nutrition and feeding regimen. The school nurse will collaborate with caregivers and healthcare providers to modify feeding times and amounts to better meet the student’s nutritional needs. Expected Outcomes The student will maintain or achieve an appropriate weight and growth pattern. The student will demonstrate improved tolerance to tube feedings. Nursing Diagnosis: Risk for Infection Related to presence of feeding tube that can introduce bacteria into the digestive system Related to increased risk of infection at the insertion site or along the feeding tube Interventions The school nurse will ensure that the tube insertion site is kept clean and dry, and that the feeding tube is properly secured to prevent accidental dislodgement. The school nurse will regularly inspect the insertion site for signs of infection, such as redness, swelling, or discharge, and notify caregivers if any signs are observed. The school nurse will educate the student and caregivers on the importance of good hygiene practices, such as washing hands before preparing feedings and cleaning the feeding tube regularly. The school nurse will collaborate with the student’s healthcare provider to ensure that proper infection prevention measures are followed. Expected Outcomes The student will remain free from signs of infection related to the feeding tube. The student and caregivers will demonstrate effective infection prevention measures. Nursing Diagnosis: Risk for Fluid Volume Deficit Related to insufficient hydration or excessive fluid loss due to vomiting, diarrhea, or inappropriate feeding schedules Related to inadequate water flushes after feeding to maintain hydration Interventions The school nurse will ensure that the student receives an adequate amount of fluids through tube feedings and additional water flushes as prescribed. The school nurse will work with the dietitian to ensure that the student’s formula and feeding schedule include sufficient fluids for hydration. The school nurse will watch for signs of dehydration, such as dry mouth, dark urine, or lethargy, and address them promptly. The school nurse will ensure that water flushes are administered regularly according to the student’s prescribed feeding protocol. Expected Outcomes The student will maintain appropriate hydration levels. The student will demonstrate no signs of dehydration during school hours. Nursing Diagnosis: Deficient Knowledge Related to lack of understanding of tube feeding procedures and care Related to misunderstanding of the importance of proper feeding practices Interventions The school nurse will provide training for caregivers and school staff on the proper procedures for administering tube feedings, including how to check tube placement, prepare formula, and handle any feeding-related emergencies. The school nurse will educate the student (if age-appropriate) about the importance of their tube feeding regimen and the foods or formulas that meet their specific nutritional needs. The school nurse will work with the family and healthcare providers to create a comprehensive care plan that outlines feeding schedules, monitoring guidelines, and emergency procedures. The school nurse will provide written instructions and visual aids for both the student and caregivers to support consistent feeding and care practices. Expected Outcomes The student, caregivers, and school staff will demonstrate knowledge and competence in managing tube feeding procedures. The student will follow the prescribed feeding regimen appropriately. Nursing Diagnosis: Risk for Altered Body Image Related to visible feeding tube, which may cause self-consciousness or discomfort Related to social stigma associated with visible medical devices Interventions The school nurse will offer emotional support to the student to help manage feelings of self-consciousness related to the feeding tube. The school nurse will, with the family’s consent, educate peers about the feeding tube and the medical reasons behind it to foster understanding and reduce stigma. The school nurse will promote self-esteem by encouraging the student’s participation in school activities and recognizing their abilities beyond the feeding tube. The school nurse will ensure that the student has the opportunity to manage their feeding process in a private, comfortable setting to minimize stress or embarrassment. Expected Outcomes The student will demonstrate improved self-esteem and body image. The student will actively engage in school and social activities without feeling self-conscious about the feeding tube. Nursing Diagnosis: Risk for Social Isolation Related to physical limitations or challenges related to tube feeding that may interfere with participation in group activities Related to fear of judgment or misunderstanding from peers Interventions The school nurse will encourage participation in non-strenuous group activities and social events that the student can comfortably engage in. The school nurse will educate classmates about tube feeding (with the family’s consent) to increase awareness and acceptance. The school nurse will be vigilant for signs of social withdrawal or reluctance to participate in group activities and address them by supporting the student’s involvement in peer interactions. Expected Outcomes The student will remain socially active and connected with peers. The student will report feeling included and supported by classmates and staff. Would you like to add another nursing diagnosis? Yes No Nursing DiagnosisNursing DiagnosisAdd your own nursing diagnosisInterventionsAdd your own nursing interventionsExpected OutcomesAdd your own expected outcomesNursing Diagnosis Add RemoveInterventions Add RemoveExpected Outcomes Add Remove Add More EVALUATIONNOTESIHP Developed ByName First Last Title Date Month Day Year Please enter a valid date. Do you want to include physician and parent signature lines? Yes Download IHP Clicking this button will download this IHP to your computer and return you to the blank IHP. Return Clicking this button will return you to the IHP to make changes.
