Gastrostomy tube

Gastrostomy tubes, where an incision is made directly through the abdominal wall, are indicated for patients who can tolerate gastric feedings but in whom long-term... 

Open the capsule and sprinkle the entire contents over approximately 10 ml of water and flush with swirling through a prewetted 16 French gastrostomy tube fitted with funnel at the port end. Additional aliquots of water are used to transfer all pellets and to flush the tube. Do not attempt the administration of pellets through a nasogastric tube. 

Figure 20-1. Growth chart, weight for length, for D.E.C. Note poor weight for length at 5 months before placement of gastrostomy tube (first arrow) and increased weight for length by 2 years 6 months, when she was admitted for metabolic studies and feeding therapies.

Children with special health care needs will require additional considerations during mass casualty or disaster care. These considerations include decontamination procedures following radiation or chemical exposure for children using wheelchairs, ventilators, or oxygen and decontamination procedures for children with gastrostomy tubes, tracheostomy tubes, indwelling bladder catheters, and indwelling central venous catheters. Replacement supplies would be needed once the cutaneous decontamination is completed. Such supplies may not be readily available, so provisions must be made to secure these items or to have comparable clean or sterile supplies on hand. 

The nasogastric tube and gastrostomy tube routines are used to administer medication when the patient is unable to swallow or ingest. 

Gastrostomy Tube (GT) This is a tube inserted through the skin into the stomach. It is used to administer medication and for permanent feeding. 

When administering medication through the nasogastric or gastrostomy tube ... 

Angus F, Burakoff R. The percutaneous endoscopic gastrostomy tube. Medical and ethical issues in placement. Am J Gastroenterol 2003 98 272-277. 

Kobak GE, McClenathan DT, Schurman SJ. Complications of removing percutaneous endoscopic gastrostomy tubes in children. J Pediatr Gastroenterol Nutr 2000 30 404 07. 

Yaseen M, Steele Ml, Grunow JE. Nonendoscopic removal of percutaneous endoscopic gastrostomy tubes Morbidity and mortality in children. Gastrointest Endosc 1996 44 235-238. 

Oral feeding should be used whenever possible. Tube feeding (Fig. 4) involves the use of small bore na.so-gastric, nasoduodenal and gastrostomy tubes. Defined diets of homogeneous composition can be continually administered. Tube feeding in this way bypasses problems with oral pathology. 

Patients who have upper gastrointestinal (GI) disturbances might have a tube inserted via the nasal passage into the stomach (nasogastric tube) or a tube inserted directly into the stomach through the skin and stomach wall (gastrostomy tube) that is used to bypass the upper GI tract and provides a direct path to the stomach. Both tubes can be used to introduce medication into the patient. 

Remove the plunger from a syringe and pour medication into the syringe. Close the clamp on the nasogastric or gastrostomy tube. 

If the patient has dismption of the upper GI tract, then the prescriber will order a nasogastric or gastrostomy tube. The nasogastric tube is inserted through the nose and into the stomach. The gastrostomy tube is inserted through the skin and directly into the stomach. Both of these tubes can be used to deliver medication to the patient. 

The nurse has just completed administering medication to a client with a cerebrovascular accident (CVA) via a gastrostomy tube. As the nurse is leaving the room, the client starts vomiting. Which action should the nurse implement ... 

The nurse is administering medications through a gastrostomy tube (GT). Which intervention should the nurse implement first ... 

The nurse should first flush the GT with tap water to ensure that it is patent before putting any medication into the gastrostomy tube. 

Faraji B, Yu P-P. Serum phenytoin levels of patients on gastrostomy tube feeding. J Neurosci Nurs ( 99S) 30, 55-9. 

Under fluoroscopic guidance the stomach is punctured and a guidewire is inserted. Using dilators the needle tract is dilated and a gastrostomy tube is placed within the stomach. The retention balloon is inflated and the gastrostomy tube is fixed to the abdominal wall using the supplied external stabilizer. 

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