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Digestive and Gastrointestinal Treatment Modalities: Study Notes

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Digestive and Gastrointestinal Treatment Modalities Purposes of Gastrointestinal Intubation Decompress the stomach Lavage the stomach Diagnose GI disorders Administer medications and feeding To compress a bleeding site To aspirate gastric contents for analysis Types of Tubes Lavage tubes Levin Gastric (Salem) Sump Enteric tubes Gastric Sump Tube Collaborative Problems and Potential Complications #1 Diarrhea Nausea and vomiting Gas, bloating, cramping Dumping syndrome Aspiration pneumonia Tube displacement Tube obstruction Nasopharyngeal irritation Hyperglycemia Dehydration and azotemia Maintaining Nutrition Balance and Tube Function Administer feeding at prescribed rate and method and according to patient tolerance. Measure gastric residual volumes (GRV) before intermittent feedings and every 4 to 8 hours during continuous feedings Administer water before and after each medication and each feeding, before and after checking residual, every 4 to 6 hours, and whenever the tube feeding is discontinued or interrupted Do not mix medications with feedings Use a 30-mL or 60-mL catheter tip syringe Maintain delivery system as required. To avoid bacterial contamination, do not hang more than 4 hours of feeding in an open system Maintaining Normal Bowel Elimination Selection of TF formula; consider fiber, osmolality, and fluid content Prevent contamination of TF; maintain closed system; do not hang more than 4 hours TF in an open system Maintain proper nutritional intake Assess for reason for diarrhea and obtain treatment as needed Administer TF slowly to prevent dumping syndrome Avoid cold TF Reduce Risk for Aspiration Elevate head of bed at least 30 to 45 degrees during and for at least 1 hour after feedings Monitor residual volumes Stop feedings 1 hour before traveling or placing head down Other Interventions Maintain hydration by supplying additional water and assessing for signs of dehydration Promote coping by support and encouragement; encourage self-care and activities Frequent oral hygiene Patient education Nursing Process: The Care of the Patient With a Gastrostomy or Jejunostomy —Assessment Patient knowledge and ability to learn Self-care ability and support Skin condition Nutrition and fluid status Inspection of the tube Nursing Process: The Care of the Patient With a Gastrostomy or Jejunostomy—Diagnoses Imbalanced nutrition Risk of infection Risk for impaired skin integrity Disturbed body image Collaborative Problems and Potential Complications #2 Wound infection, cellulitis, leakage GI bleeding Premature dislodgment of tube

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