Game Plan for day Three

Goal for today: Increase the pedialyte rate by 10ml's every 2 hours (as long as she tolerates the rate increases)

if she tolerates the full rate increases to the target goal by tonight or tomorrow slowly decrease pedialyte and increase Neocate Jr formula this weekend. Then start trialing Elecare formula early next week...

Also a major J-tube disaster was averted by a simple question to the nurses. The orders for meds to not be placed in her J-tube and only in her G-tube had not been specified, and so I had been asking if we were supposed to be placing meds in her J-tube yet due to volume issues. Well because of this they had been placing the meds in the g-tube portion.

Then this morning her compounded prevacid I asked "are you sure the prevacid goes in her J-tube? Doesn't it need to be put through the G-tube to help with stomach acid? In J-tube how can it help with stomach acid?" With a puzzled look the nurse went to ask someone else and she came back letting me know I was right that it does need to be in the stomach, not the intestines.

Then when the GI dr's came this morning they made sure the nursing staff knew how to handle the G and J tubes, what can be pushed a larger and faster rate and not, what rates go where, and when and how to increase. Oh and they made sure to change the orders to NO meds in the J-tubes ONLY G-tubes!