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

  1. 0
    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 !!!
  2. 16 Comments so far...

  3. 0
    I never check residuals on a J-tube. On a G-tube, yes. Shouldn't an x-ray be done to check placement?
  4. 0
    Quote from Michigan RN
    I never check residuals on a J-tube. On a G-tube, yes. Shouldn't an x-ray be done to check placement?
    This is a HH patient.. sent home with a Jtube for feedings. Wouldn't you want to check for placement by aspiration anyway?
  5. 0
    Quote from jnette
    This is a HH patient.. sent home with a Jtube for feedings. Wouldn't you want to check for placement by aspiration anyway?
    I never had to. I always though that the j-tube was too small to aspirate. I could be wrong.
  6. 0
    i always check for residual.
    can't assume sm intestine is perfectly functional.
    as for placement, don't know how you could unless x ray.

    leslie
  7. 1
    Just a guess. I never thought you could check residual on a J-tube because any contents that are in the jejenum don't sit there like they do in the stomach. I could be totally wrong though.
    leslie :-D likes this.
  8. 2
    Quote from earle58
    i always check for residual.
    can't assume sm intestine is perfectly functional.
    as for placement, don't know how you could unless x ray.

    leslie
    How would you check for residual in teh small intestine? It doesn't "hold" anything..it's not a "container" as the stomach is. Wouldn't it just all run through the length of the small intestine? I mean what's to "hold" it for awhile, as the stomach would do? And if yu aspirated, would you not just be getting runny "poop" ?

    And you could be drawing up a LOT of "residual" I would think... those intestines are LONNNNNNNNNNNNNG......... I may be all wrong..as I said, I need some clarification on this. What kind of residual would I be expecting from a Jtube? It wouldn't be anything like stomach contents/juices.. the G tube residual content.
    oldiebutgoodie and leslie :-D like this.
  9. 1
    J-tubes are a poor indicator of residuals. And you shouldn't try to aspirate through it because j-tubes have tendency to clog easily.
    leslie :-D likes this.
  10. 2
    no, it's just me.
    clinically/technically michigan and jnette, you can't check for residual.
    yrs ago i was trying to unclog a jtube and when i finally did, i got a lot of blood.
    this pt had pancreatic ca, and the md thinks his bowel perf'd.
    he was a mess.

    anyways, since that time, i've always checked residual in the population i work with...
    although i don't get a heck of a lot of jtubes.
    oh, and another time, i was told it was a jtube, when in fact, it was a g-j tube...where you do check residual.

    so no, you really don't have to check.
    besides, if the fdg is not infusing, there will be other telltale signs.

    leslie
    fuuchan and RN1982 like this.
  11. 0
    Quote from Michigan RN
    Just a guess. I never thought you could check residual on a J-tube because any contents that are in the jejenum don't sit there like they do in the stomach. I could be totally wrong though.
    Yes.. that's what I was thinking.


    Quote from earle58
    no, it's just me.
    clinically/technically michigan and jnette, you can't check for residual.
    yrs ago i was trying to unclog a jtube and when i finally did, i got a lot of blood.
    this pt had pancreatic ca, and the md thinks his bowel perf'd.
    he was a mess.

    anyways, since that time, i've always checked residual in the population i work with...
    although i don't get a heck of a lot of jtubes.
    oh, and another time, i was told it was a jtube, when in fact, it was a g-j tube...where you do check residual.

    so no, you really don't have to check.
    besides, if the fdg is not infusing, there will be other telltale signs.

    leslie
    OK.. this had me curious. He was sent home from the VA.. and his papers said he had had teaching on checking placement and residual. He had acute pancreatitis and they bypassed the duodenum and placed a temprary Jtube. His discharge papers said he teaching on all the above. Got me to wondering. Perhaps they did the "run of the mill" teaching on Gtubes in general?

    I've not seen him, we just admitted him.. but was curious as to what our policy should be, and what to include in his plan of care regarding his teaching, Jtube care, etc.

    I appreciate the feedback!


Top