Which strategy may increase the amount of feeding delivered in patients with high GRVs?

Which strategy may increase the amount of feeding delivered in patients with high GRVs?

• A. Holding feedings
• B. Increasing number of checks
• C. Small bowel feeding
• D. Elevating head of bed only

Answer: (C)

When gastric residuals are high, the stomach isn’t tolerating the feed well, which often leads to interruptions as clinicians try to reduce the risk of aspiration. Delivering the nutrition into the small intestine bypasses the stomach, so the feed doesn’t pool in the stomach and produce large residuals. This post-pyloric (small-bowel) feeding generally improves tolerance and allows the prescribed amount to be delivered more consistently, helping to meet nutritional goals. Holding feedings would reduce what’s given, and simply increasing checks doesn’t address the underlying tolerance issue. Elevating the head of the bed helps with aspiration risk but doesn’t bypass gastric delay, so it’s less likely to increase the total delivered volume when high GRVs are the problem.

When gastric residuals are high, the stomach isn’t tolerating the feed well, which often leads to interruptions as clinicians try to reduce the risk of aspiration. Delivering the nutrition into the small intestine bypasses the stomach, so the feed doesn’t pool in the stomach and produce large residuals. This post-pyloric (small-bowel) feeding generally improves tolerance and allows the prescribed amount to be delivered more consistently, helping to meet nutritional goals.

Holding feedings would reduce what’s given, and simply increasing checks doesn’t address the underlying tolerance issue. Elevating the head of the bed helps with aspiration risk but doesn’t bypass gastric delay, so it’s less likely to increase the total delivered volume when high GRVs are the problem.