A Research Study On Using Ng Tube Feeding

Promptness is very important when monitoring feeding tubes. If a tube is clogged and it is not reached quickly, the patient is going without nutrients they need. A clogged tube basically starves the person because no formula is permitted to flow through the tube.

Nasogastric tube insertion is a common procedure for registered nurses at the patients bedside. The tube “is inserted through one of the nostrils, down the nasopharynx, and into the alimentary tract” (Berman & Snyder, 2016, para. 3). The stomach is the aim for nasogastric tube insertion, however, the tube can be misplaced. Misplaced tubes can cause severe complications and even death. The current “gold standard” for feeding tube placement confirmation requires the use of a x-ray over the abdomen. Even though performing

Before a procedure begins, the nurse anesthetist will discuss with a patient any medications the patient is taking as well as any allergies or illnesses the patient may have. This must be done so anesthesia can be safely administered. Nurse anesthetists then give a patient general anesthesia to put the patient to sleep so they feel no pain during surgery or they may administer a regional

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

The majority of nurses are still auscultating air insufflation over the abdomen to check the placement of nasogastric tubes, since it was the method that was taught for many years. It is an easy and less expensive way to check the placement, but research has shown that it is not reliable. Research showed that sounds can be transmitted to the epigastrium no matter where the nasogastric tube is placed. It does not matter if it is in the lungs, esophagus, or stomach, it can still be heard through the stethoscope (De Boer, J., Smit, B., Mainous, R., 2009).

Although when it happens, there can be a devastating impact on patients as well as to the multidisciplinary theatre team involved. Consequently, the DAS has produced a consensus set of guidelines for managing failed intubations in adult and paediatric patients, but there are as yet no such nationally-agreed guidelines in obstetrics, therefore each obstetric unit should have their own flowchart with regards to management of failed intubation (Brien and Conlon, 2013). Furthermore, in light of the latest DAS guidelines, several aspects of clinical anaesthetic practise have changed over recent years (Frerk at al, 2015). Amongst the changes are the use of new drugs such as rocuronium and suggamadex and using electronic video-laryngoscopes (Frerk et al, 2015). Further work had also looked at extending the period of apnoea without causing desaturation by optimising the preoxygenation process and adequate patient positioning (Frerk et al, 2015). As a result, updated guidelines for difficult intubations in adult patients were published in 2015; these guidelines provide a flowchart to be used when endotracheal intubation proves difficult or impossible and focus on the central importance of oxygenation while reducing the amount of airway interventions in order to minimize trauma to the delicate airway (Frerk et al, 2015). The main message of the revised guidelines is

Although different kinds of tubes are placed in a patient at the bedside every day, it is important to remember the complications that can arise if a tube in not placed correctly or in the right place. Health care workers recognize this risk and take steps to ensure proper insertion. This study recommends that health care workers use at least two bedside methods to verify placement. These include, pH, visual signs of aspirate, patient’s respiratory condition, monitoring the tube every four hours, marking the exit location of the tube and capnography. These methods have all been backed by research to show their validity in determining tube placement. Although included on the list, the auscultation of an air bolus is not included in one of the recommended bedside tests. Although it is widely used in practice, the article states that “no evidence indicates that the auscultatory method is useful for determining the location” ( Methany 2016). If heath care providers relied on the auscultation method as one of the recommended bedside tests, the tube could be in the wrong place in the body or in the lungs. If feedings or medications were given through the tube in the wrong place it could lead to extreme complications or even death. This article notes x ray as, again, the gold standard for ensuring placement. This article along with several

The patient will require surgery to repair the hole in the intestines, and subsequently will have a drainage tube, NG tube, and feeding tube. All drains will need to monitored for placement/movement, and drainage. Input and output will be closely monitored and recorded. The patient will remain on NPO, or nothing by mouth, to rest the bowels along with frequent assessments to monitor for infection and bleeding. The nurse will need to monitor for bowel sounds, vital sign changes, temperature changes, pain, abdomen girth, and wound/incision inspections. The following labs will require monitoring: CBC, H&H, albumin, BUN & creatinine, glucose, and ABG’s and lactic acid if sepsis is suspected. Careful and frequent monitoring of labs will alert the nurse if the patient develops sepsis, or hypovolemia due to excessive bleeding (Belinhof, et al., 2012). In addition to vital signs and labs, the nurse will also include patient assessment into consideration before drawing conclusions by means of critical thinking. After the full assessment has been made, the nurse will report any findings to the health care provider that require further investigation or

In reality, this group of people is just like the others. People with peg tubes can be active in sports and live a fun life. It is up to them to do whatever one desires. These group of people are judged to an exaggerated point of view as if one is not able to do much because of the tube being “in the way.” The tube is not there to bother an individual, it can be put out of the way to stop one from thinking it is actually there. In the website article, “To Tube or Not To Tube,” written by Luis F. Amador, MD, the author states, “PEG tube feeding can provide long-term enteral nutrition and hydration with low risk for complications.” Amador argues the stereotype that goes around where people claim “they don’t live a normal life,” because he said it himself that the peg tube provides much more nutrition than the normal person might get on a daily basis, which is very healthy for the body, decreasing chances of one getting

The patient is a 45 year old man who had GI surgery 4 days ago.  He is NPO, has a nasogastric tube, and IV fluids of D51/2saline at 100 mL/hr.  The nursing physical assessment includes the following:  alert and oriented; fine crackles; capillary refill within normal limits; moving all extremities, complaining of abdominal pain, muscle aches, and "cottony" mouth; dry mucous membranes, bowel sounds hypoactive, last BM four days ago; skin turgor is poor; 200 mL of dark green substance has drained from NG tube in last 3 hours.  Voiding dark amber urine without difficulty.  Intake for last 24 hours is 2500mL.  Output is 2000mL including urine and NG drainage.  Febrile and diaphoretic; BP 130/80; pulse 88; urine specific gravity 1.035; serum

An eighty-three-year-old man named Mr. Duffy had a cardiovascular accident in the right thalamus section of his brain. The CVA has caused numerous medical problem and severe cogitative impairments. A nasogastric feeding tube was inserted, but it was pulled out by the patient. The tube is not reinserted because of extensive tissue death in the nasal cavity. Mr. Duffy's medical team recommends that a gastrostomy tube be inserted.

The tracheostomy is a common surgical procedure which is performed in the Intensive Care Unit (ICU), as opposed to the operating room (OR). The patient is given general anesthia, a 2-3 cm incision is make from the second tracheal ring down divide the thyroid isthmus if needed. A hole is made between the third and fourth tracheal rings where a tracheostomy tube which are given by their inner and outer diameter, curvature and length to fit the patients’ trachea is inserted. A chest x-ray may be taken to check that the tube is correctly in place and there are no complications. The patient is often placed on a ventilator (breathing machine) to assist with breathing.

According to Middleton, Teefey and Darcy,8 TIPS placement is successful in about 90% of patients, but does hold a complication rate of 10-16%. Research has shown that placement of TIPS as a secondary treatment for variceal bleeding has produced encouraging results. In 13 random clinical trials, including over 900 patients, recurrent variceal bleeding rates were 9-40%, which is superior to endoscopic treatments that have recurrent bleeding rates from 20-60%. This success rate has made TIPS procedures more utilized in the setting of variceal bleeding. Additionally, the same clinical trials indicate that ascites reduction after shunting ranges from 38-84%, which is favorable to large volume paracentesis that reported rates of 0-43%. “Compared with large-volume paracentesis, TIPS improved transplant-free survival and the incidence of recurrent ascites in cirrhotic patients with refractory ascites.”26 There is evidence of an increase in the development of HE in patients who undergo TIPS, whereas endoscopic treatment does not show an increase. Furthermore, HE is twice as likely to occur when paracentesis is performed. An important consideration is that the complication rate for hepatic encephalopathy does increase with TIPS usage whereas it doesn’t with endoscopic treatment and it is twice as likely to occur as when paracentesis is performed.28 Presently, TIPS is often used as a temporary solution for patients who are

Patient preparation before undergoing tips procedure is very important. First the patient need to undergo preoperative evaluation and portal vein is assessed with duplex sonography. If the finding are inconclusive, use of other method to evaluate

• An upper gastrointestinal (GI) series. This is an X-ray exam of your GI tract involving the use of a chalky liquid that you swallow. The liquid shows up clearly on the X-ray.