Gastrointestinal System and Nasogastric Tube Feeding

Study Notes

Provides the body with water, electrolytes, and other nutrients used by cells
Functions to break down ingested food, propel food through the GI tract, absorb nutrients, absorb water and salts, and eliminate waste

A gastrointestinal tube inserted into the stomach, duodenum, or intestine
Indications: decompress the stomach and remove gas and fluid, lavage the stomach, diagnose disorders of GI motility, administer medications and feedings, treat an obstruction, compress a bleeding site, and aspirate gastric contents for analysis
Contraindications: diffuse peritonitis, severe pancreatitis, intestinal obstruction, severe diarrhea and vomiting, and paralytic ileus

Administration of nutrients directly into the GI tract
Most desirable and appropriate method of providing nutrition is the oral route, but this is not always possible
Nasogastric feeding is the most common route
Contraindications: diffuse peritonitis, severe pancreatitis, intestinal obstruction, severe diarrhea and vomiting, and paralytic ileus

Short tubes: passed through the nose into the stomach
Medium tubes: passed through the nose to the duodenum and jejunum, used for feeding
Long tubes: passed through the nose, through the esophagus and stomach into the intestines, used for decompression of the intestines

Assess the patient's need for NGT
Get the patient's consent
Assess the patient's nares, esophagus, and abdomen
Check the gag reflex and mental status
Gather equipment and wash hands
Position the patient at 45°, or drape chest with towel or disposable pad
Assess abdominal examination
Determine the length of the tube to be inserted
Lubricate the tube with water-based lubrication
Insert the tube, encouraging the patient to swallow and advancing the tube downward and backward
Check placement by asking the patient to talk, checking the mouth with a light and tongue blade, and securing the tube

Indications: retention of urine, obstruction of the urethra, urine output monitoring, collection of a sterile urine specimen, nerve-related bladder dysfunction, and imaging study of the lower urinary tract
Contraindications: use cautiously in patients with a history of pelvic or perineal trauma associated with perineal bruising and swelling and/or blood at the meatus, and urethral strictures or anatomically false passages

The balloon can break while the catheter is being inserted
Urine flow is blocked
Infection in the urine increases with the number of days the catheter is in place