G tube displacement?

[wiltmich]

Hi! I'm a brand new nurse only 6th day alone. Anyway, my question pertains to one of my patients' g tube. I was flushing it, which takes a bit of force which I find to be uncomfortable, and I noticed sutures about 3 inches up around the tube, visible, and not sutured to her! The portion of the tube under the sutures was a darker color... I knew immediatly her tube had become dislodged. We had a abdominal x ray and it stated a bunch of normals and ended with "the g tube overlies the stomach"... Is that a good thing? I called to report to md

but left before she called back, now I'm off for the weekend . I'm sitting here worrying that I pulled on it or something cause it was a tough tube but the patient didn't react with pain and there was no bleeding or trauma to the site when I noticed the site . Patient is also altered mental status and I've seen her hand playing around the site before

[firstinfamily, RN]

If it is your day off it is time to stop worrying!!! I am assuming this is a new G-tube otherwise it would not have sutures attached to it, if the x-ray says it is laying on top of the stomach I am not sure if it means it is in the top area of the stomach or laying outside the stomach wall. I kind of question the x-ray. With a new G-tube if it becomes dislodged usually the MD has to replace it because the tract for the tube has not really formed yet. You were right to notify the MD. The pt may have to go out to have the g-tube replaced. If you were meeting a lot of resistance it might have had a clog of some sort in it. In the future if a G-tube seems clogged don't continue to force flush it, try to get a little carbonated fluid(soda) into it as this will dissolve the clog in most cases. You did nothing wrong, you notified the MD. Hopefully, the oncoming shift will not continue to try to use the tube and the pt will get a new one.

[wiltmich]

Thank you for your reply! I did as much research on the phrase "overlies the stomach" as I possiblly could.. I'm guessing it means it's at the top of the stomach wall which would be normal for a g tube. If the x ray found the g tube to be displaced shouldn't it state that the g tube is displaced? The patient was a new admit day 2, it was the first time I accessed the tube.. Other nurses did it after me and I didn't receive anything in report the next day that the g tube was abnormal... Aren't some tubes more difficult than others.... If the sutures were newly pulled out wouldn't there be bleeding or skin trauma to the site??? Ahh so many questions. Starting out in this profession can really make you hold your breath sometimes.