Gastrointestinal System and Nasogastric Tube Feeding

Gastrointestinal System

• 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

Nasogastric Tube

• 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

Enteral Nutrition

• 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

Types of Tubes

• 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

Equipment

• NGT (8-12 Fr)
• 60 ml syringe
• Tape
• Cup of water with straw
• Emesis basin
• Water-soluble lubricant
• Normal saline solution (for irrigation only)
• Safety pin
• Gloves
• Suction equipment
• Pen light
• Tongue blade
• Stethoscope
• Towel
• Gel

Procedure

• 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

Risks of Displacement

• Due to vomiting, suctioning, severe coughing, and moving/transferring

Removal

• Check the discharge order
• Instruct the patient to hold their breath
• Gently and smoothly remove the tube
• Document the removal

Foley Catheter Placement

• 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

Risks

• 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

This quiz covers the basics of the gastrointestinal system, its functions, and the role of nasogastric tubes in feeding. It's designed for students of nutrition and healthcare professionals.