Gastrostomy Tube Feeding by Gravity

Document created by tfreiberg Employee on Dec 27, 2016Last modified by mcunningham on Mar 20, 2017
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Purpose


Tube feedings are sometimes used for patients who have trouble swallowing or cannot take food or medicine through their mouth.

 

The feeding tube that goes into the stomach through the nose is called a nasogastric (NG) feeding tube. A tube that is placed through a small hole in the skin into the stomach is called a percutaneous endoscopic gastrostomy (PEG) or (G-Tube).

 

Supplies you will need


  • Prescribed formula at room temperature
  • 60 cc syringe

 

What to do


  1. Wash your hands.
  2. Explain to the patient what you are going to do, even if you are unsure whether they can hear.
  3. Help the patient to sit up – or elevate the head of the bed.
  4. Place a clean towel on the patient’s chest area to protect from spillage.
  5. Unclamp the feeding tube.
  6. Uncap the end of the feeding tube or remove the covering. 
  7. To be sure the tube is in the correct place in the stomach:
    • Attach the 60 cc syringe to the feeding tube and pull back on the plunger.
    • You should feel some resistance
    • Within a few seconds you should see stomach fluid (green/yellow).
    • Gently push this fluid back into the stomach.
  8. Remove the syringe from the end of the feeding tube. Unclamp the tube.
  9. Remove the plunger from the barrel of the syringe.
  10. Put the tip of the syringe into the feeding tube. Unclamp the tube.
  11. Slowly pour ¼ cup of warm water into the syringe that drains into the feeding tube. Do not hold the syringe higher than 12 inches above the stomach.
  12. Do not force the water in the tube. Allow gravity to drain the syringe.
  13. Fill the syringe barrel with formula. Continue to slowly pour the prescribed amount of formula into the syringe barrel until the feeding is complete.
  14. It should take about 15 minutes to give 1 cup of feeding. If the formula goes in too fast the patient may have stomach upset.
  15. If the syringe becomes empty, air may enter the stomach and cause upset. Clamp the tube to refill the syringe if you need to.
  16. When the formula has been given, pour another ¼ cup of warm water into the syringe barrel to flush the feeding tube.
  17. Clamp the feeding tube and remove the syringe barrel.
  18. Plug the end of the tube or cover to keep it clean.
  19. Wash the syringe and plunger in warm soapy water and allow to air dry.
  20. Store in a clean-covered container. 
  21. Wash your hands.
  22. Have the patient remain in the sitting position for 30-60 minutes.

 

Special instructions


  • Prepare only enough formula that can be used within a 24-hour period.
  • Refrigerate any unused formula -- but allow to come to room temperature before inserting it into the feeding tube.
  • Call your nurse if you cannot see stomach fluid when checking for placement of the patient's feeding tube.
    • Or if the formula does not go in easily
    • Or if the patient complains of pain, nausea, vomiting or cramping
    • Or if the tube falls out

 

Adapted from: Harkreader, H., & Hogan, M.A. (2007).  Fundamentals of nursing: Caring and clinical judgment. St. Louis: Saunders.

 


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