Gastric Tubes Flashcards
what are nasogastric tubes used for?
gastric decompression
enteral feedings/water
administering meds
irrigation
what could cause a GT to be used for feedings?
a brain injury
why would a GT be used for decompression?
bowel obs, bleeding, ileus of bowel after sx
what does PEG stand for?
percutaneous endoscopic gastrostomy
what are residual volumes and what can they tell us?
they are what is left undigested after a feeding
they can tell us how well bowel is functioning
what are two types of feeding tubes and how are they different?
nasogastric (large bore/dual lumen or small bore/single lumen)
PEG long term, surgically placed
why is a large bore NGT used?
gastric emptying (decompression) due to:
-bowel obstruction,
-post GI sx,
-GI bleed
feeding
med admin.
gastric lavage
what is the purpose of the vented tube?
allows stomach to decompress and allows air back into stomach
what is are the two types of suction?
continuous: increased risk of gastric mucosal irritation
intermittent: more common
what are the things we check when maintaining gastric suction?
external part secure
check suction
check tubing
irrigate (20-30mL) H2O to maintain patency
maintain air vent
what is gastric lavage? and when would it be used?
washing in and out
used for removing poison w/ activated charcoal
in a GI bleed to remove blood clots
enfit tubes have _______ ports one is for ________ and the other is for __________
two ports
suction and meds
what is done to determine that the placement is correct with NG tubes?
x-ray confirmed
aspirate gastric contents (note color)
measurement of NG tube
insufflation (air into epigastric area and listen for gurgle)
pH check of gastric contents
capnography
NG tubes are inserted using ________ technique
clean
what are the performance standards for enteral tubes?
- verbalize rationale for type of tube and references
- verify order
- place gastric tube and assess placement
- verify correct suction and set up
- asses skin integrity and abdomen
- secure tube
- assess for migration by noting tube measurement at nares
- flush as ordered to maintain patency
what is the nursing assessment for Ng tubes?
abdominal assess
verify placement
monitor intake and output
note color and character
attention to nasal and oral care
gastrostomy tube info
long term enteral feeding device
surgically/endoscopically placed in stomach by a physician
larger diameter than small bore
percutaneous endoscopic gastrostomy tube
what is the mic-key gastrostomy tube for?
people who are not going to pull the tube out who cannot eat for whatever reason… younger, more functional people
what are the indications and methods for enteral feeding?
indications:
-malnutrition
-inability to swallow or
chew
methods:
-continuous 50mL/hr
-bolus 200 mL q 4hr
what are some hazards/ complications for gastrostomy tubes?
aspiration
diarrhea
abdominal cramping
bloating
N/V (nausea and vomiting)
soy allergies?
what do we document in cerner regarding NG tubes?
under tubes and drains:
-types
-length inserted
-in/out
What are the requirements for enteral feedings?
physicians orders
checking residuals
return residuals
change container and tubing per policy
what is the recommended Bed elevation for enteral feedings?
HOB up 30-40 deg at least
during continuous feedings or 2 hr after bolus
hold enteral feeding per physicians orders:
ex: hold if residual _______
> 150mLs
