Gastric and intestinal tubes PDF

Preview

Summary

Download Gastric and intestinal tubes PDF

Description

Broward College NURSING DEPARTMENT

GASTRIC AND INTESTINAL TUBES 1. Intestinal Tubes Used for Decompression

Types Harris Tube and Cantor Tube • A mercury-weighted single lumen opening for the drainage. • Balloon inflated containing 25 ml of mercury (according to age, size, and condition of the patient). Miller-Abbott Tube • Double lumen catheter • One lumen for administration of mercury post insertion and the other is for drainage and

Health Alterations I

Purpose To drain fluids and gas that accumulates in GI and intestinal systems (Decompression)

Facts The balloons act like a bolus of food stimulating peristalsis and tube advancement The mercury propels the tube in the absence of peristalsis - Never tape tube until desired position has been obtained Irrigation may be ordered to assure patency Light food may be ordered when tube is well advanced into the colon

1

Patient Care Progression of the tube is accomplished by appropriately positioning the patient. Immediately after insertion position patient right side for 2hrs post insertion back for 2hrs with head elevated left side for 2hrs Walking increases peristalsis Tube is advanced 1-4 inches every few hours (specified in orders) Monitor for spontaneous return of: Bowel sounds, passage of flatus, and bowel movement Pin excess tubing to patient - Provide comfort measures: Throat lozenges, and ice

Slindor 8-19

irrigation

2. Tubes

chips

Gastro-Specialty

Types Senstaken-Blakemore Tube

Health Alterations I

Purpose The tube is designed to remove blood or gavage stomach with ice water and to provide pressure to esophagus and gastric wall to stop bleeding

Facts Is an esopho-gastric tube which has three lumens and two balloons: - Nasogastric suction lumen - Gastric balloon lumen - Esophageal balloon lumen

2

Patient Care Esophageal balloon is left inflated for a maximum of 48 hours Gastric balloon must be deflated regularly to prevent erosion and ulceration Monitor tube output Monitor for respiratory problems Tube shifting can cause obstruction of air way Patient is unable to swallow and can aspirate, provide tissues, basin, and

Slindor 8-19

suction set up Mouth care Q1-2 hours

3. Enteral Tubes

Feeding

Salem Sump Tube Types Major Categories 1. Gastrostomy Tubes 2. Jejunal Tubes 3. Nasogastric Tubes

Purpose

Facts

1. Gastrostomy Tubes

Used for long term feeding patient not able to have PO intake large

1. Percutaneous Endoscopic Gastrostomy Tube (PEG Tube)

Health Alterations I

3

Slindor 8-19

Patient Care Assess patency of the tube Irrigate/Flush the tube Verify the suctions as ordered Monitor tube output Monitor for respiratory problems Patient is unable to swallow and can aspirate, provide tissues, basin, and

lumen catheters inserted by MD

2. Jejunal Tubes Universal adapter double lumen catheter • Red Port - Jejunal feeding tube •

• •

Used when feeding into distal duodenum or jejunum is necessary (ileus)

Blue Port - Gastric decompression and medication administration Balloon Port - for inflation Flushing Port - on universal adapter

3. Nasogastric Tubes

To decompress and feed into the stomach.

1.

* The air vent should never be clamped off, connected to suction, 2. or used for irrigation.

Health Alterations I

endoscopic insertion and removal 2. Surgical Gastrostomy Tube, inserted via laporostomy - Low profile gastrostomy (buttons) have anti-reflux valves 1. Percutaneous Endoscopic Jejunal Tube (PEJ Tube) passed via gastrostomy tube. Has double lumens for gastric and jejunal access. Placed endoscopically with fluroscopy 2. Needle Catheter Jejunostomy Tube. Small size lumen 5-7 Fr. This is the most commonly used jejunostomy tubing. Surgical placement and suturing of tube is required. Surgical gastrojejunostomy is a double lumen catheter. It is placed into the stomach and passed through the jejunum. Requires abdominal surgery. 3. Nasojejunal Tube is a single lumen catheter. It is placed in the small intestine via endoscopic and fluoroscopic techniques. Levin Tube single lumen tube; small bore feeding tube can be used for long and short term duration Salem Sump Tube double lumen tube; one remove gastric contents and the other to provide an air vent. This tube is preferable for stomach decompression. - The Salem sump tube has a blue “pigtail” is the air vent that connects with the second lumen.

4

Slindor 8-19

suction set up Mouth care Q1-2 hours Retape the tube to avoid pressure on naris

- When the tube’s main lumen is connected to suction, the air vent permits free and continuous drainage of secretions.

Health Alterations I

5

Slindor 8-19...