This document discusses various gastrointestinal procedures including nasogastric tube insertion and removal, gastric lavage, gastric aspiration, gastric gavage, and gastrostomy. It defines each procedure, describes its purpose, necessary equipment, potential complications, nursing considerations, and more. Key points covered include how NG tubes are used to administer feedings or remove stomach contents, the types of gastric aspiration, purposes of gastric lavage and gavage, and nursing care for patients with gastrostomies.

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2. • Definition: Method of introducing a tube through nose
into stomach for feeding purpose.
• A NGT is a soft rubber or plastic tube that is inserted
through a nostril and into the stomach.
Purpose
– To administer tube feedings and medications to
clients unable to eat by mouth or swallow a sufficient
diet
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3. – To lavage (wash) the stomach in case of poisoning or
overdose of medications
– To remove stomach contents for laboratory analysis.
– To establish a means for suctioning stomach contents
to prevent gastric distention, nausea, and vomiting
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4. • equipment for NGT.docx
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5. • Contraindications
• Child with epistaxis by gravity
• Child with nasal polyp
• Cleft palate or any other congenital
abnormalities around the nose and mouth
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7. • It is the irrigation or washing out of the stomach.
Purpose
• To remove alcoholic, narcotic or any other poisoning which
has been swallowed.
• To introduce ice water or normal saline solution in tackling
bleeding.
• To cleanse the stomach before operation.
• To relieve congestion, there by stimulating peristalsis
• For diagnostic purposes.
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8. • Gastric lavage.docx
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10. • It is the withdrawal of fluid or gas from a cavity by suction.
Purpose
• To prevent or relieve distention following abdominal
operation.
• In case of gastrointestinal obstruction, to remove the stomach
or gastric contents.
• To keep the stomach empty before an emergency abdominal
operation is done.
• To aspirate the stomach contents for diagnostic purposes.
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11. There are two types of gastric aspiration
• Intermittent method: Suction is done as condition
required and as ordered.
• Continuous method: attached to a drainage bag.
There are two types of supplying suction.
• Simple suction by the use of a syringe
• An electric suction machine
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12. • Equipment for gastric aspiration.docx
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13. Gastric gavage
• providing nutritional supplement when the patient is
unable or not willing to take food per mouth with
normal GI tract functioning.
Purposes
To provide total supplemental nutrition
Restore fluid, electrolyte and acid base balance.
Reduce or eliminate catabolism and negative
nitrogen balance.
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14. • Equipment for Gastric Gavage.doc
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15. complications
• Diarrhoea
• Nausea/ vomiting
• Cramping/ gas
• ™
Constipation
• ™
Aspiration pneumonia
• ™
Tube displacement
• ™
Tube obstruction
• ™
Nasopharengeal irritation
• ™
Hyperglycaemia
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16. NGT Removal
• process of withdrawing the nasogastric tube which
was placed in client’s stomach for different purpose
• NG tube is removed:-
-when clients nutritional status doesn’t warrant EN
therapy
- Providing decompression of gastric contents no
longer needed
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17. • Procedure of NGT removal .doc
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19. • Surgical operation in which an opening for a tube is
made through the wall of the stomach and joined to an
opening in the adjacent abdominal wall.
• It allows food and liquids to be placed directly into the
stomach via a tube when the esophagus is affected by
disease or recovering from surgery
• Used to give food to a patient who has a gastrostomy
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20. • Regurgitation and aspiration are less likely to occur with
gastrostomy than NG feedings
• Gastrostomy is preferred for prolonged enteral nutrition
support (longer than 4 weeks).
• It is preferred over NG tube feeding in the patient who is
comatose because the gastro esophageal sphincter
remains intact
• It allows clients greater mobility than gastric or duodenal
tube feeding and enables client to feed themselves.
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21. • Equipment for gastrostomy.docx
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22. The patient with Gastrostomy
Assessment
• Evaluate the patient’s skin condition and determine
whether a delay in a healing at the tube insertion site.
• Asses the patient’s fluid and nutritional need.
• Inspect the tube for proper maintenance and the incision
for sign of infection.
• Evaluate the patient response to the change in body
image and his/her understanding of the feeding methods.
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23. Diagnosis (Nursing Diagnosis)
• Risk for infection related to presence of wound and
tube.
• Risk for impaired skin integrity tube insertion site.
• Disturbed body image related to presence of tube.
• Imbalanced nutrition less than body requirement related
to enteral feeding problems.
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24. Planning and goals
• Attaining an optimal level of nutrition
• Preventing infection
• Maintaining skin integrity
• Enhancing coping
• Adjusting to change in body image
• Preventing complication
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25. Nursing Intervention
• Applying a small dressing over the tube insertion site.
• Wash the area around the tube with soap and water daily
removes any encrustation with saline solution.
• Calm discussion of the purpose and routine of
gastrostomy feeding.
• Closely monitor the V/s of the patient.
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26. • Evaluation
• Achieves an adequate intake of nutrients
• Is free from infection and skin breakdown.
• Adjust to change in body image.
• Avoid complication
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27. Potential complication
• Wound infection
• Cellulites
• Leakage and abdominal wall abscess.
• GI bleeding
• Constipation or diarrhea
• Aspiration
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