GTube, med administration..HELP

[perksrn]

I am looking for some info on med administration through G tubes. I have seen some nurses administer meds by gravity (which takes a long time, even with dilute meds) and others use gentle push with bulb or syringe. What's the nursing standard? If "pushing" with syringe, what's the best way to draw up to avoid the instillation of air and pt distention? Also on G tubes, what is the standard for aspirating, measuring and documenting residual. Some say only if ordered, some say q4.

If you have info or a good website regarding this, I would love it.

Thanks!!!

[leslie :-D]

LTC LPN - Don't you change tubes? I was suprised when I read they have to go to hosp for tube replacement.

Earle 58 - We always keep spare g-tubes or buttons just for replacement for damage or age. Usually damage, they never seem to last long enough to have to be replaced because of age with all the pulling and tugging so many kids seem to be able to "give" their tubes.

yes in a perfect world, there would be backup for those pts. that have gtubes.

actually there was never any problem with supplies until the DON decided that she and the ADON would be the only ones to order supplies via a secret pin #, which we weren't privy to. that's when all the problems began.

and then there were 'some' that when a gtube was pulled out, nothing was placed in the stoma, thus it closed up. :stone

[DANRN2000]

As a LTC nurse, I always check for placement before I do anything else. When giving meds through a g-tube, I crush the med powder fine, then mix with a little water (unless it's contraindicated). For liquids, I'll give them as-is, then follow up with the flush as ordered...usually 60 or 120 cc water. The best way to give the meds is by gravity, but we all know that some of these tubes just DON"T cooperate that way...you can stand there for 30 minutes and the syringe is still full! So a gentle push is all that's needed. I'm a firm believer in properly flushing these tubes....if one is ever found stopped up when I come on duty, it's a write up. Period. If flushed correctly and as ordered, they should never become stopped up. And I've un-stopped some whoppers in my time!:angryfire :angryfire :angryfire

Edit: Also, I never intentionally push air into a resident. Although I've read of other nurses "unstopping" tubes by forcefully pushing air through the tube...which ends up giving the res a painful case of gas! And I've heard of nurses using soda pop to unstop tubes, too. Our facility uses de-cloggers but only as a last resort. I have save many from an unnecessary trip to the hosp for tube replacement because I was able to unclog the tubing. What's bad is when the lazy nurse sends the res to the ER with a stopped up tube and the ER flushes it and sends them right back...and the family gets the ambulance & hosp bill for $$$ and demands to know what happened...while the Er staff is laughing at us for being "those idiots at the nursing home"....

Why not use "write up" as a last resort. Maybe re-education is in order. Fellow nurse may appreciate your tips and expertise.

[LTC_LPN]

Why not use "write up" as a last resort. Maybe re-education is in order. Fellow nurse may appreciate your tips and expertise.

It's no longer a "last resort" because I've worked with the same nurses at the same nursing home now almost 2 years...and we've been inserviced and inserviced on this subject repeatedly. Yet amazingly, we still have the same problems. Notes left in the med room about flushing tubes, notes left on the pumps as reminders. Some people are just plain lazy...and they don't care. But since we're so short staffed, our dept. heads are happy to have the nurses we do have.:angryfire