Gastric Decompression Flashcards
purpose of NG tube
- to decompress or drain stomach of fluid/gastric secretions
- instill solutions like meds and feedings into stomach
- used for pt with conditions when peristalsis is absent
reasons for decompression
- rest GI tract
- clear GI tract
- Pt is NPO
why would a pt need to rest the GI tract
-severe vomiting and diarrhea
-diverticulitis, Crohn’s
Monitor GI bleed
why a pt need to clear the GI tract
- treat distention
- intestinal obstruction
- paralytic ileus
- promote healing
types of nasogastric tubes
- levine tube(single lumen)
- salem sump (2 lumen)
levine tube
lacks venting system
mucosal damage can occur when suction is applied
suction is applied intermittently
Salem sump tube
- double lumen
- clear lumen: empties stomach content
- blue lumen: provides continuous flow of air to prevent the clear lumen from pulling stomach lining into tube opening thus preventing gastric mucosal damage
- one way anti reflux vlave may be used in the air flow lumen to prevent reflux of gastric content thru the airflow lumen
- pressre causes the valve to close preventing contents from leaking out the blue
- irrigate with normal saline
enteral nutrition: short term feeding: Nasogastric tube
- nose to stomach
- no for long term feeding
internal nutrition: short term feeding: n’as-duodenal tube
- Nose to duodenum
- thin and flexible tube
enteral nutrition: enterostomal tube: gastrostomy tube
- surgically inserted into stomach from abdominal wall
- use 2-3 days after insetion
enteral nutrition: enterostomal tube: percutaneous endoscopic gastrostomy
- inserted into stomach from abdominal wall
- insertion does not require general anesthesia
- use within hours of insertion
enteral nutrition: enterostomal tube: percutaneous endoscopic jejunostomy
- inserted into jejunum form abdominal wall
- use with stomach problem and delayed gastric emptying
Enteral feeding: feeding infusion: continuous
always used for intestinal feedings
-pump limits mobility
internal feeding: feeding infusion: intermittent
- resembles normal eating schedule
- permits more flexibility and mobility
does a person need to be NPO to have enteral feedings
Can be NPO or not
common complications of feedings and NGT
- aspiration
- clogged tube
- nasal erosion
- diarrhea
- unplanned removal
- stomach infection (GT)
- dumping syndrome
what causes dumping syndrome
- feeding is too cold
- feeding is too rich
- delivery to intestines is too fast
how to prevent complications of feedings
- check residual, do not routine discard
- check mark with inedible ink
caring for NG/NI tubes and PEG
- secure tube to nose and gown
- assess site placement and inflammation
- sire care: cleanse peristomal skin and use skin barrier
- rotate guard 360 degrees QD (daily)
caring for NG/NI tubes and PEG
- secure tube to nose and gown
- assess site placement and inflammation
- sire care: cleanse peristomal skin and use skin barrier
- rotate guard 360 degrees QD (daily)
inserting NG Tubes
- prea assesment
- measure nose to tip of ear lobe to xiphoid
- position 45-90 degrees
- advance tube : watch for coughing and signs of distress
- secure tube and mark with indelible marker
Assessing and confirming placement
-apiration: color
-capnometer: measure CO2
-air insertion
measure length of exposed tubing
-assess pH (less than 5.5)
-chest x ray(only initially)
caring for NG tube
- abdominal assessment
- monitor gastric output
- asses adeque of suction pressure: no drainage and n/v
- maintina tube patency
- anti reflux valve
- oral hygiene
NG irrigation
- positon 30-45 degrees
- instill irrigate slowly
- subtract irritant from NG output
- inject air into vent
documentation of NG tube
- type and size of tube
- nare used
- method of placement confirmation
- patient response to care measures
- teaching that was done
tubes used for continuous suction
-salem sump tube
tubes used for intermittent suction
- salem sump tube
- levine tube
suction
- use lowest suction possible
- provide will order intermittent or contious
- pigtail must be above level of stomach
intermittent suction order
80mmHg- 100mmHg
continuous suction order
60-100mmHg
removing NG tube
- assessment: explain procedure, unsecured tube
- placement: marker or pH
- flush with 30-50mL of air
- comfortable positioning
- instruction to hold breath to avoid aspiration
- give tissues and emesis basin
documentation
- condition of nare skin
- I and Os
- tolerance of procedure
- patient teaching: abdominal pain, n/v, bloating
