J Tubes... checking placement/residual???

[jnette]

Quick question... am I correct in thinking that since the J peg/tube is in the small intestine, there is really no way of accurately checking any residual ?

Do we check residual at all in a J tube prior to administering a tube feeding?

What about checking PLACEMENT?

I understand with a G tube, NG tube, etc., all the above are more than neccessary, and that placement in a J tube would appear neccessary as well, but I need some input or clarification.

Any feedback appreciated !!! ? ? ?

[PICNICRN, BSN, RN]

I think the only "real" way to check placement is by XR, but if the tube is transpyloric, you can usually get a "snap" when you aspirate- the plunger snaps right back to the tip of the syringe. With the little ones sometimes you will hear a swoosh of air louder on the rt of the abd compaired to the lt.

However, I don't think either of these ways are the "correct" way to check placement- you have to have the XR confirmation.

[PICNICRN, BSN, RN]

OOPS...... after re reading the post I know see that you are not talking about a NJ tube but rather a surgically placed J tube-----

Sorry......... just ignore me!

[morte, LPN, LVN]

it is my understanding that you NEVER aspirate a Jtube....that in trying to do so , you may "suck" on the intestinal wall..........and it would be very unlikely to have a residual....placement, about the onlything you can do, is measure the length of tube on the outside, if it changes, address with doc... and make sure, if they used a "foley" cath, that the baloon is NOT inflated..... Yes,it does sound like they used the Gtube teaching....geesh

[jnette, ASN, EMT-I]

Thank you, everyone, for your responses.. you have confirmed my initial thoughts. I've not had any Jtubes so far to deal with, only an occasional G tube. But Gtube protocol just didn't seem to "fit" with the Jtube... thanx again ! :)

[Delvis]

Don't ever check placement or residuals on a J-tube. They are surgically placed, where would they migrate to? Possibly stomach, but that is a far possibility. If you pull back on a syringe while attached to a j-tube port you could cause the end of the tube to adhere to the inside wall of the small intestine. You could cause a GI bleed!

Hope this helps.