Lecture Notes: GI System Tubes

Objectives

• Differentiate tubes used for various gastrointestinal disorders.
• Describe indications and patient assessments for each type of tube.
• Explain nursing responsibilities for patients with GI tubes.

General Purposes of GI Tubes

• Decompress the Stomach: Suction out contents.
• Lavage the Stomach: Wash out the stomach.
• Diagnose GI Disorders: Insert for scoping or contrast media for imaging.
• Administer Medications/Feedings: Deliver nutrients or drugs directly.
• Compress Bleeding Sites: Control hemorrhages.
• Aspirate Contents: For analysis.

Key Nursing Questions for GI Tube Management

• Purpose of the tube?
• Care and maintenance orders?
• Proper location and securement?
• Patency and usability?
• Expected type and amount of drainage?
• Patient and equipment assessment frequency?
• Potential complications?
• Patient and family education?
• Documentation frequency and content?

Types of Feeding Tubes

Nasogastric Feeding Tubes

• Enter through the nose, end in the stomach.
• Dobhoff Tubes: Used for liquid nutrition.
• CorePak Tubes: Commonly seen in clinical settings.
• Placement Monitoring: Use markings on the tube.

Percutaneous Endoscopic Gastronomy (PEG) Tubes

• Surgically inserted through the abdomen into the stomach.
• Suitable for long-term feeding.

Jejunostomy (J-tube)

• Bypasses the stomach, ends in the jejunum.
• Useful when stomach cannot be used for feeding.

Administration Methods

• Gravity Feeding: Adjust height to manage flow rate.
• Kangaroo Pump: Allows for continuous or bolus feedings.
  • Includes bags for feeding solutions and water flushes.
  • Change system every 24 hours.

Suction Tubes

Salem Sump Tube

• Large bore with an air vent for gastric decompression.
• Removes gastric secretions.

Levin Tube

• Similar function to Salem sump.
• Ensure proper placement and functioning.

Feeding vs. Suction Tubes

• Feeding Tubes: For administering nutrition/meds (may need crushing).
• Suction Tubes: For removing contents, usually NPO status.
  • Meds can be administered if ordered and conditions are right.

Tube Suctioning

• Order specifies suction amount: low, medium, high.
• Continuous vs. intermittent suction.
• Monitor for damage to the stomach lining.

Maintenance Considerations

• Ensure tight connections and proper function.
• Address leaks, kinks, and clogs promptly.
• Use water or sterile solutions for irrigation.

Enteral Feeding

• For short-term therapy (orally/nasally inserted tubes).
• Contraindicated in certain facial injuries and conditions.
• Placement confirmed by X-ray initially, monitored by tube markings.

Parenteral Feeding

• Through IV lines, used when oral/enteral feeding is inadequate.
• Types of central venous access: PICC lines, tunneled, implanted ports.
• Requires strict sterile technique.

Nursing Responsibilities

• Identify candidates for parenteral nutrition.
• Monitor for weight loss, muscle wasting, nausea/vomiting.
• Maintain fluid/electrolyte balances and monitor glucose levels.

Conclusion

• Rewatch discussions, seek different learning resources, and use instructor support as needed.
• Understand the critical role of nurses in managing all aspects of GI tubes.

Additional Study Recommendations

• Review textbook resources, especially for disease associations.
• Familiarize with Chapter 41, Table 41-7 for complications associated with feedings.