Procedure - G-Tube Replacement

Question 1

Before you insert the new G-tube, always ________________.

Answer 1

make sure the balloon inflates properly

Question 2

How do you know how much fluid to infuse into the G-tube?

Answer 2

It will say in the booklet that comes with the kit (if you’re inserting a new one) and it says on the port itself (if you don’t have the kit).

Question 3

How can you check if the G-tube is in properly?

Answer 3

Aspirate gastric contents. If there’s no blood on aspiration and it infuses and draws back easily then it is likely in the right place.

You can do a fluoroscopic study but this isn’t necessary.

Question 4

The two dimensions to G-tube size are ______________.

Answer 4

tube diameter (given in French catheter sizes) and length (given in cm)

Question 5

The three categories of how G-tubes are placed are _______________.

Answer 5

surgical (in which the ostomy is sutured to the abdominal wall), VIR (may be anchored or may not), and endoscopic (not anchored)

Question 6

Early dislodgement of an endoscopically placed tube can cause _______________.

Answer 6

peritonitis

Question 7

Review the home care of G tubes.

Answer 7

• Flush tube w/ 30 mL of water per day
• Turn the bumper halfway and insert in and out gently each day
• No submersion for the first 10 days

Question 8

In addition to pancreatic enzymes, you can also try _________ to dislodge a tube.

Answer 8

carbonated beverages or Seldinger wires

Question 9

Do not replace a tube if it is _____________.

Answer 9

a fresh tube (3-4 weeks)

Having an immature tract increases the risk of false-tracking.

Question 10

What do you need to replace a G tube?

Answer 10

• Replacement tube and smaller size
• 20 mL sterile water (no saline because of concern of crystallization)
• Syringe
• Chloraprep
• Lube
• Toomey syringe

Question 11

If the insufflation balloon will not deflate, you can try _________________.

Answer 11

popping the balloon with a guide wire

Question 12

What is buried bumper syndrome?

Answer 12

If a kid is lost to follow up and outgrows the tube size, the port and bumper can pinch the abdominal wall and lead to gastric erosion. This presents with severe abdominal pain and may have outer signs of erosions or tightening of the skin around the port as well as tenderness on the inner bumper.

Question 13

If you need a G tube at UNC, call _________.

Answer 13

the VIR charge nurse

Question 14

After how much time is a G-tube track mature enough to blindly place a new one?

Answer 14

2-6 weeks by most recommendations