GIT - CLE

Question 1

Indications for nasogastric tube (NGT) insertion

Answer 1

• short term feeding
• decompression of stomach
• medication administration
• gastric lavage
• oral rehydration

Question 2

Patient Position for inserting an NGT

Answer 2

-

Question 3

Equipment needed for insertion of an NGT

Answer 3

• gloves
• tube
• water based lubricant
• bluey
• tape measure
• syringe
• tissues
• glass of water & straw
• securing tape
• kidney dish
• litmus paper
• spigot

Question 4

How to measure length of an NGT

Answer 4

• tip of nose to
• tip of earlobe to
• xyphoid process
• mark on tube with tape

Question 5

Procedure for insertion

Answer 5

• lubricate tube
• gloves
• check patency of nostrils - ask preference
• ask to blow nose (if capable)
• insert tube gently, push up towards back of nose
• go slowly & gently
• ask patient to swallow when tube is in back of throat (while inserting tube)
• once in stomach, secure to nose with tape
• spigot or attach to drainage bag
• test for position - xray, litmus paper
• once confirmed - measure from tip of nose to end of tube, record measurement

Question 6

Potential complications of insertion of an NGT

Answer 6

• aspiration (tube into lungs)
• tissue trauma (if tube unlubricated, tears oesophagus as it goes down)
• positioning when feeding, temperature of feed, can lead to dumping syndrome (where food passes through stomach too quickly, causes expansion of small intestine, cramping, bloating, pain)

Question 7

Stoma - Definition

Answer 7

• artificial opening surgically created that brings the bowel to the surface of the abdomen so feces can leave the body

Question 8

Ileostomy vs Colostomy

Answer 8

• ileostomy
  
  • formed from ileum in small intestine
  • discharge is liquid or pasty in consistency
  • discharge occurs several times a day, usually after meals, unable to be controlled
• colostomy - formed from colon in large bowel
  • ascending colostomy = right side of abdomen
  • stool is liquid / semi-liquid, rich in digestive enzymes & irritating to skin surrounding stoma
  • transverse colostomy = middle of abdomen
  • stool is liquid / semi-formed, usually less irritating to surrounding skin
  • descending colostomy = left side of abdomen
  • stool is semi-formed - most of the water has been absorbed as it travels through ascending & transverse sections of the colon
  • sigmoid colostomy = lower left side of abdomen
  • stool has a normal, formed consistency

Question 9

Types of stoma

Answer 9

• end stoma
  
  • formed from the end of remaining bowel after permanent removal of remainder of bowel
• loop stoma
  
  • created to protect an anastomosis, or aid healing in GIT disease or divert fecal flow in an emergency

Question 10

Stoma observations

Answer 10

• colour of stoma
• size of stoma
• output - consistency, colour, odour
• any oedema
• surrounding skin

Question 11

Signs & symptoms of stoma related complications

Answer 11

• leakage
• skin damage due to ill fitting appliances
• odour
• prolapse
• hernia (outpouching)
• stenosis (narrowing)
• ischemia
• retraction
• fistula formation (abnormal connection / passageway, not surgically created)