Question about secretions

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Specializes in Med/Surg., Geriatrics, Pediatrics..

I care for a impaired child with a g-tube and recently he has been having increase secretions, gas and occasional emesis during and after feeding. During assessment, his lung sounds are clear, but the rattling sound, sounding almost like rhonchi, is coming from his throat. How would you document the lungs are CTA, moist secretions heard from throat? To me that's too unprofessional and I would like to document secretions heard from larynx/pharynx area vs. throat. How would you document this is you were the nurse?

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Specializes in NICU, ICU, PICU, Academia.

The sounds you are referring to are 'upper airway noise'. Breath sounds are clear, upper airway congestion heard'. How's that?

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yup. transmitted upper airway congestion is what we chart at my facility.

Regarding his gas/emesis, have you tried venting his tube pre/post feeding? After feeding you can attach an empty 60cc syringe to his tube and formula/air will move up into the tube and the formula will go back in via gravity as the air is removed.

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Specializes in Med/Surg., Geriatrics, Pediatrics..
yup. transmitted upper airway congestion is what we chart at my facility.

Regarding his gas/emesis, have you tried venting his tube pre/post feeding? After feeding you can attach an empty 60cc syringe to his tube and formula/air will move up into the tube and the formula will go back in via gravity as the air is removed.

When you chart "Transmitted upper airway congestion" are you saying the secretions are transmitted from the lungs, or bronchial passages to the upper air way?

Yes, I have vented his g-tube several times and he only expels small amt. of gas. I'm new at peds. I've worked in Med/Surg, Women's health, Tele and ER, never peds. They pull me here knowing I don't really care for it. Maybe when I get use to peds, I will like it more. umcRN, when you vent a child and he expels gas, do you document as "child vented, small amt. of gas expelled."? And thanks so much for your input, you've been a great help.

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Specializes in Med/Surg., Geriatrics, Pediatrics..
The sounds you are referring to are 'upper airway noise'. Breath sounds are clear, upper airway congestion heard'. How's that?

Thank you so much, marycarney. Please read my comment for umcRn and add your imput. Thanks so much.

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Specializes in NICU, ICU, PICU, Academia.
When you chart "Transmitted upper airway congestion" are you saying the secretions are transmitted from the lungs, or bronchial passages to the upper air way?

Yes, I have vented his g-tube several times and he only expels small amt. of gas. I'm new at peds. I've worked in Med/Surg, Women's health, Tele and ER, never peds. They pull me here knowing I don't really care for it. Maybe when I get use to peds, I will like it more. umcRN, when you vent a child and he expels gas, do you document as "child vented, small amt. of gas expelled."? And thanks so much for your input, you've been a great help.

Well, I would say instead "G-tube vented" not "child vented" first off :) . We actually refer to this (and chart as such) as 'burping' the tube. So I would chart 'Mic-key gastrostomy tube 'burped' for small amount of residual air'. (Or whatever type of g-tube they have)

And 'transmitted' refers to the sound, not the secretions.

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Specializes in Med/Surg., Geriatrics, Pediatrics..
Well, I would say instead "G-tube vented" not "child vented" first off :) . We actually refer to this (and chart as such) as 'burping' the tube. So I would chart 'Mic-key gastrostomy tube 'burped' for small amount of residual air'. (Or whatever type of g-tube they have)

And 'transmitted' refers to the sound, not the secretions.

lol.... thanks, marycarney, that's exactly what I meant, g-tube vented...lol You've been a wonderful help.

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