Published Jan 25, 2007
sweetieann
195 Posts
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!
Ann RN
221 Posts
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 PegsThanks!
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
cardiacRN2006, ADN, RN
4,106 Posts
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.
loriannlpn
98 Posts
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?
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
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.
chenoaspirit, ASN, RN
1,010 Posts
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.
tatgirl
150 Posts
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
morte, LPN, LVN
7,015 Posts
residual is applicable, placement is not....were is a Gtube going to go?
rita359
437 Posts
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)..
mocaj
25 Posts
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.
ILWannabeRN
12 Posts
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!