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Gastrointestinal Intubation

Gastrointestinal Intubation . Nasogastric— goes to stomach for either suction or feeding Nasoenteric— goes to duodenum or jejunum for either suction or feeding. Types of Tubes. Suction tubes —Levin (NG), Salem Sump (NG), Cantor (NE)

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Gastrointestinal Intubation

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  1. Gastrointestinal Intubation • Nasogastric—goes to stomach for either suction or feeding • Nasoenteric—goes to duodenum or jejunum for either suction or feeding

  2. Types of Tubes • Suction tubes—Levin (NG), Salem Sump (NG), Cantor (NE) • Feeding tubes—Levin (NE), Dobbhoff (NE), gastrostomy (PEG), jejunostomy (both open to abd wall)

  3. Suction Tubes: Indications • Decompression to relieve intestinal obstruction • Lavage to control bleeding • Confirm diagnosis by aspirating stomach contents

  4. Feeding Tubes: Indications • Supplementation--Short term medication and nutritional management via NG or NE tube. Usually given by intermittent bolus. • Risk for aspiration--Provides long term medication and nutritional management via ostomy. Usually given by pump.

  5. Formula • MD will decide type based on status of GI tract, nutritional needs of pt, and presence of disease • Most are started in diluted state • Pt will need water supplement

  6. Complications from Tube Feedings • Aspiration • Tube dislodgement • Tube clogging • Bacterial contamination • Dehydration • Diarrhea • Hyperglycemia

  7. Nursing Responsibilities • Assess nutrition & fluid balance • Know policies re: hanging time and tube changes • Monitor pt tolerance/complications • Check for residual (usually ordered) • HOB up • Emotional support

  8. Home Care • Initiated in hospital; F/U by home health nurse • Family education: • Check for placement • Monitor feedings/change bags and tubes • Do site care • Do oral hygiene • Monitor for complications • Call MD or nurse for questions or concerns

  9. Insertion Technique for NG and NE tubes • Insertion is thru nose • Use NEX measurement + 6 inches for NG and 8 inches for NE • Technique: See Fundamentals skills and watch video

  10. Checking for Placement • Listen with stethoscope • Put tube in glass of water • Aspirate contents (preferred) • X-ray (confirmation)

  11. Securing Tube • NG tubes can be taped to nose and cheek right away after placement is determined • NE tubes are taped to forehead or cheek with plenty of slack to allow for advancement of 2-3 inches every hour. Change positions q 2h.

  12. Nursing Responsibilities • Check for placement • Check suction settings • Monitor feedings (continuous or bolus) • I&O • Hygiene • Irrigation (if ordered) • Clamping tubes • Monitor for complications

  13. Removal • Clear line with air before removing • Have pt hold breath • Remove NG smoothly and quickly • Remove NE at intervals q 10 min until it reaches esophagus • Conceal in towel • Provide oral hygiene

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