perform gastronomy feeding

Perform Gastronomy Feeding

This is feeding of a patient by means of an opening directly into the stomach through the
abdominal wall.

They are commonly surgically inserted endoscopically through the abdominal wall, and held in place by an internal
balloon or bumper and external fixator. Gastrostomy feeding is a successful method of enteral feeding
providing daily nutritional requirements in specialist liquid form directly into a patient’s stomach via a
flexible tube.

Indications
• Carcinoma of the esophagus.
• Strictures of the esophagus.
• Operations of the upper gut i.e.; Alimentary canal, mouth, nose and esophagus.
• Birth defects of the mouth.
• Esophageal atresia.
• Problems with sucking or swallowing ie ; in patients with debilitated diseases like stroke and
dementia.

Methods of feeding via a gastrostomy
  • Bolus feeding: A volume of liquid feed given usually via a gravity set over a short duration, e.g.
    15–20 minutes.
  • Continuous feed: This is a feed given via an electronic feeding pump, which allows clinicians and
    home caregivers to deliver set amounts of enteral formula in a consistent manner, over a desired
    duration of time.
Types of feeding tubes

Long tubes
> PEGs (percutaneous endoscopic gastrostomy)
> Long balloon-retention tube
> Malecots 

Skin Level Tubes
>Firm silicone mushroom retention, (BARD, etc.)
>Balloon retention (AMT MINI, MICKEY, etc.)

 

Complications of gastronomy feeding
  • Tube obstruction
  •  Primary malposition
  •  Perforation of the intestinal tract
  • Secondary displacement of the feeding tube
  •  Knotting of the tube
  •  Accidental tube removal
  • Breakage and leakage of the tube Leakage and bleeding from insertion site
  •  Erosion, ulceration and necrosis of skin and mucosa
  •  Intestinal obstruction (ileus)
  •  Hemorrhage
  •  Inadvertent IV infusion of enteral diet
  •  Infection at the tube insertion site
  •  Aspiration pneumonia
  •  Nasopharyngeal and ear infection
  •  Peritonitis
  •  Infective diarrhea
  •  Electrolyte disturbances
  •  Hyper- and hypoglycemia
  •  Vitamin and trace element deficiency

Procedure for administration of  Gastrostomy feeding.

REQUIREMENTS

A tray containing;
• A bowel containing funnel/feeding syringe, rubber tubbing, glass or plastic connection.
• Feed at a suitable temperature [37-38] 240 to 300mls of strained nourishing fluid in a
bowel of warm water.
• Towel and mackintosh cape
• Warm water in a glass measure container
• Spigot in a sterile receiver.
At the bedside: hand washing facility, screen .

PROCEDURE
  • Observe the general rules of nursing procedure.
  •  Expose the gastrostomy catheter to aid easy working.
  • Protect the bed linen with a mackintosh and a towel to prevent soiling of the bed.
  •  Wash hands and check temperature of the feed to prevent spread of infection.
  • Aspirate and measure the stomach contents before giving the feed to ensure feeds are absorbed.
  • Pinch proximal end of the gastrostomy tube and connect funnel after removing the spigot to avoid air entry into the stomach.
  • Pour 10mls of water into the funnel let it run through the tube slowly and followed by a prescribed amount of feed. Rinse the tube with 10mls of warm boiled water to ensure patent tube through the procedure.
  • Pinch and disconnect the funnel when feeding is over and replace the spigot to prevent air entry into the stomach and back flow.
  • When the wound has not healed carry out gastrostomy toilet i.e. Clean skin around the tube with normal saline and apply a protective cream e.g. zinc oxide and cover with dry dressing to promote healing and prevent infections.
  • Record the type of food amount given & time to monitor input and output.
  • Provide oral hygiene , clean equipment & leave the patient comfortable to prevent infection to the patient.
  • Clear the tray and wash hands to prevent cross infection.

COMPLICATIONS OF GASTROSTOMY FEEDING
> Wound infection
>Leaking from a wound made during surgery.
> Chest infection.
> Internal bleeding.
> Blockage of the small intestines.
> Stricture –where stomach acid leaks up into your oesophagus and cause scaring leading
to narrowing & constriction of the esophagus over time.
> Blockage of the small intestines.

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4 thoughts on “Perform Gastronomy Feeding”

    1. Thanks for the knowledge
      I only suggest that at least every complication should be given with a rasionale
      This is in reference with “chest infections”, “Intestinal obstruction “

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