gastrostomy tube

  1. I always thought that with a g-tube/PEG tube, you still had to check placement and measures residuals before administering feedings and/or meds. A nurse I asked says no. Who's right? I know you wouldn't check these things on a j-tube or dobhoff, but ithought you did with NGs and Pegs

    Thanks!
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  2. 14 Comments

  3. by   Ann RN
    Quote from sweetie715
    I always thought that with a g-tube/PEG tube, you still had to check placement and measures residuals before administering feedings and/or meds. A nurse I asked says no. Who's right? I know you wouldn't check these things on a j-tube or dobhoff, but ithought you did with NGs and Pegs

    Thanks!
    G Tube - yes
    J Tube - no
    Dobhoff - yes, but must be done properly or you will collapse the tube. Use
    a 10cc syringe & pull back SLOWLY. I once got 320cc residual this
    way.

    Ann
  4. by   cardiacRN2006
    I checked residuals once on a peg tube and got over 600 of rotten tubefeeds. So it's still important to check.

    Agree with using a 10cc with a DHT.
  5. by   loriannlpn
    I am a nursing student, finishing up my last quarter of ADN, ( LPN now) I have read in several different charts of one dictation saying that a J tube was inserted, and read in another dictation that a Gtube was inserted. Is there a sure fire way to ensure which is which? Jpegs are higher on the anterior aspect of the abd, correct?
  6. by   TheCommuter
    Regarding g-tubes/PEG tubes, the textbook method is to always check placement and measure residual before giving meds and administering feedings. However, I will freely admit that there are many nurses who cut corners to save time by just pushing the meds/feedings down the tube without checking placement and residual.
  7. by   chenoaspirit
    Yes, you check residual of a G-tube. There is a risk for aspiration and you also want to ensure that the stomach contents are emptying.
  8. by   tatgirl
    I always check g-tube placement and residual before giving meds and feedings. This only takes a minute or two. Fortunately on my floor there are only 6 tube feeders. There is a place on the MARS for these residents for the amount of residual obtained. As TheCommunter posted there are nurses who dont do this to save time and cut corners.....

    Wendy
    LPN
  9. by   morte
    residual is applicable, placement is not....were is a Gtube going to go?
  10. by   rita359
    Quote from morte
    residual is applicable, placement is not....were is a Gtube going to go?

    Never seen them wander up the gi tract but they can wander down.
  11. by   morte
    Quote from rita359
    Never seen them wander up the gi tract but they can wander down.
    yup, and that you are going to know by the decrease in length (external)..
  12. by   mocaj
    Thanks for this thread. I have had the same question and have asked several nurses, all experienced. Most said they checked placement by pushing air into the tube and listening, but then I asked them why, because I thought the tube has a locking ring on the other end that is in the intestines and pushing air into it, to me, wasn't really doing anything. Now a NG-tube definate because it can be pushed and pulled and is secured by tape. But I couldn't understand the reasoning behind the peg. And I can understand if it does become unlocked then the tube would get shorter...

    Residuals are very important- How long do you wait before checking residuals? Some of these same nurses said 15-20 minutes and others said right away, there is no wait. I agree with the no wait because if you are on a constant feeding then waiting 15-20 minutes is not realistic to someone on constant.
    Last edit by mocaj on Jan 25, '07
  13. by   ILWannabeRN
    Hi! I'm just a newbie...a first year nursing student, but I was "shadowing" an RN about 3 weeks ago, and she DID check residuals...I don't think it can hurt can it? Better be safe than sorry!
  14. by   jjjoy
    Ah the frustrations of conflicting info! Some say Yes! always check placement and residuals. Others say No! no need. I can use my own understanding of it to determine how to proceed but my own understanding could be incomplete or out-dated. Well, then do some research to find out what's the latest and greatest, right? But I don't have time for that when the feeding is going now. And it's not that easy to find a definitive answer anyway. Different sources may give different answers.

    Shouldn't someone higher up be checking on these things and writing protocol so that the nursing practice is consistent among the staff versus the original conflicting practice and reasoning?

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