A tube-fed patient develops diarrhea. What should be done first?

In the case of a tube-fed patient developing diarrhea, reviewing the osmolality of the feeding is a pivotal first step. High osmolality formulas can lead to gastrointestinal distress, causing symptoms like diarrhea. Before making any adjustments to the feeding rate, switching the formula, or seeking medical consultation, it is essential to ensure that the formula being used is appropriate in terms of its osmolality.

This approach addresses a common cause of diarrhea in tube-fed patients, which is often linked to the osmolality of the enteral formula. If the osmolality is too high, it may not be tolerated well by the patient’s gastrointestinal tract, leading to increased stool output. By first evaluating this factor, the healthcare provider can identify whether the formula needs to be adjusted or switched based on the patient's tolerance.

Subsequent actions, such as adjusting the feeding rate or consulting with a physician, might be necessary but should follow the initial review of the formula's osmolality to ensure that the patient is receiving a feeding that their system can handle. This step lays the groundwork for more complex interventions if the initial cause is not resolved.