When checking gastric tube residual...

[student_nurse_07]

Hi, again. I thought of another question.

When checking residual in pts getting tube feeding via g-tube, do you aspirate untill you meet resistance? I heard that it could be irritating and possibly damaging to the gastric mucosa. Is that true? If so do I need to check residual via gravity?

Also is it traumatic to instill medication via g-tube by pushing it with plunger through the syringe rather than by gravity?

Thanks again!!!

[RoxanRN]

Hi, again. I thought of another question.

When checking residual in pts getting tube feeding via g-tube, do you aspirate untill you meet resistance? I heard that it could be irritating and possibly damaging to the gastric mucosa. Is that true? If so do I need to check residual via gravity?

Also is it traumatic to instill medication via g-tube by pushing it with plunger through the syringe rather than by gravity?

Thanks again!!!

The key word here is 'gently.' Residual is usually checked using a tomey syringe and gentle aspiration until no more fluid is aspirated or resistance is met. The pressure should be no more than what is used when low, intermittent suction is used for an NG. I don't think you would be an accurate residual if checked by gravity. This would definitly be patient position dependant.

Ideally, medications/fluids should flow easily into a GT by gravity. But there are medications/bolus tube feedings out there which are thick and can take forever if only gravity is used (or the GT is unusually small). With these, again, gentle pressure with the plungers is fine. This also gives you an opportunity to assess for some sort of blockage if the fluid does not free-flow when it should.