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.
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.
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
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 ! :)
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!
PICNICRN, BSN, RN
465 Posts
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.