Gastric Residual...what would you do in this situation? - page 2

Hi everyone, I have a random question about a situation that once happened to me in clinical during nursing school (I'm preparing for interviews and polishing my stories from all of my clinical... Read More

  1. Visit  kids profile page
    4
    I've pulled (and dumped) residuals of that size, that guiac'd negative, off of tube feeding patients in the past.
    The op didn't get into the details of the 'brown' but formula that has been sitting in the stomach for a long time can be very brown and only a bit grainy (past the curdled stage).
    Every. Single. Patient. crashed not long afterward and was found to have a SBO.
    When you pull 2000 cc off the belly of someone who is on Jevity at 60cc an hour, it becomes very apparent that residual checks haven't been done.
    GrnTea, RNperdiem, Sugar Magnolia, and 1 other like this.
  2. Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  3. Visit  Anna Flaxis profile page
    1
    Yes, SBO was the second thought....could the brown be stool? Or would we only see stool backing up if the obstruction was lower than the small bowel? I've heard of people with bowel obstructions vomiting stool, though I have never seen it, thank goodness!
    Esme12 likes this.
  4. Visit  amoLucia profile page
    0
    Quote from Sun0408
    mindlor, a foley bag hooked to the peg is a great trick for excessive stomach contents without suction.. I used it a few times, the last guy I pulled 2100 and then asked the doc if I could just hook the bag to the peg for gravity drain.. When the guts not working, some tricks come in handy
    Love it!!! Nursing is a lifelong learning process and this ancient one just learned a new tip. TY TT TY
  5. Visit  applewhitern profile page
    1
    "Contrary to your instructor's desires??" Personally, I would be wondering just how much clinical experience this instructor had. So many nursing school instructors have been "out of the bedside" for a long time, and some went straight into teaching without much actual, hands-on experience. This would have been a great teaching situation for this instructor; too bad she/he disagreed with the MD, instead of using the situation for teaching you.
    Esme12 likes this.
  6. Visit  GitanoRN profile page
    0
    Quote from applewhitern
    this would have been a great teaching situation for this instructor; too bad she/he disagreed with the md, instead of using the situation for teaching you.
    i agree 100%, however, at times the most logical procedures are viewed to some individuals as foreign, even when an experienced md tries to enlighten their views. once again i would reenforced that one has to follow their facility guide lines when in questioned.
  7. Visit  Whispera profile page
    0
    I'm wondering if your instructor's disagreement with discarding the residual was her thinking that it should be tested to see what was making it brown and yucky, and not her belief that it all should be reinstilled. Maybe she didn't communicate the whole story to you and/or maybe you didn't catch everything she was throwing???
  8. Visit  Whispera profile page
    0
    Stargazer wrote:
    Quote from ~*Stargazer*~
    Yes, SBO was the second thought....could the brown be stool? Or would we only see stool backing up if the obstruction was lower than the small bowel? I've heard of people with bowel obstructions vomiting stool, though I have never seen it, thank goodness!
    I worked with patients with bulimia for awhile. They could bring stool up in their vomit...

    ...just a blast from the past!
  9. Visit  Anna Flaxis profile page
    0
    Quote from Whispera
    Stargazer wrote:

    I worked with patients with bulimia for awhile. They could bring stool up in their vomit...

    ...just a blast from the past!
    Oh my!
  10. Visit  RNOTODAY profile page
    0
    1200 is alot, and evidence of no peristalsis, as sais previous. so it would be dAngerous and pointless to put it back. they are not digesting!!!!
  11. Visit  Tess Deco RN profile page
    0
    It depends on why you are checking gastric residual. A pt with that much residual obviously isn't moving gastric content through his GI tract. The NG should probably be connected to low wall suction so that the residual is removed over hours, instead of pulling 1200cc out all at once. I would expect the pt to have peripheral IV fluids infusing for hydration and to replace volume loss and maintain their blood pressure.

    I would guaiac the gastric residual but I can't think of any reason to keep it, especially if the doctor is informed and says to discard it. You certainly would not put the withdrawn gastric content back into the patient via the NG.

    Good luck!


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

Top