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Objectives: At the end of this session, the nurses will be able to:
!! Define

PEG tube. !! Identify the indications of PEG tube and its uses. !! Determine ways to manage a patient with PEG tube. !! Review the procedural steps of PEG tube feeding and nursing care. !! Identify complications of the presence of a PEG tube. !! Understand & apply the nursing process in the care of a patient with PEG tube.

Percutaneous Endoscopic Gastrostomy (PEG)
!! Is

an endoscopic medical procedure in which a tube is passed into patient’s stomach through the abdominal wall !! It!may also be extended into the small intestine by passing a jejunal extension tube (PEG-J tube) through the PEG tube and into the jejunum via the pylorus

Indications of PEG:
Unconscious patient - Neuromuscular swallowing disorder -! Upper GI obstructions, impaired GI motility
-

- Specific treatment - Extremely high nutrient requirements -! Mechanical ventilators -! Mentally incapacitated / Psychological problems

Which of the following patients may not benefit from enteral nutrition?
A)! patient who has a brain injury B) A patient with oral cancer C) A patient with paralytic ileus D) A patient with burns of the lower extremities!

Answer: C

NURSING CARE

Skin Care

Maintaining the feeding tube

Feeding Administration

Monitoring Patient’s response to feeding

Adjusting Feeding Schedule

Patient Teaching

1. The nurse is preparing to administer a medication to a client receiving a continuous feeding via a PEG tube. Prior to administration, the nurse takes what action? A.! Mix the medication with at least 30 ml of the formula the client is receiving. B.! Aspirate feeding, and check for residual volume. C.! Ensure feeding is running at 50 ml or greater. D.! Position the client on the left side, with the head elevated 90 degrees.

Answer: B

Too much information?

Organize with Sections

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Complications
1.! Leakage 2. Skin Irritation 3. Occlusion 4. Dislodgement 5. Hemorrhage 6. Gastric Ulcer 7. Fistula 8. Burried Bumper Syndrome
1st priority – assessment & protecting skin integrity Keep site clean & dry; topical treatments Flushing the tube before & after introducing anything into tube Assessment for the placement of tube Pain & abdominal assessment; Pain treatment Assessment; Treatment with pain Occasionally, surgical takedown of the fistula is indicated Dissection of the buried appliance from the abdominal wall

Which of the following is NOT an appropriate technique for administering enteral formulas?
A)! Continuous feeding pump B) Through a large vein C) Intermittent gravity drip D) Large-bore syringe (bolus) Answer: B

THANK YOU! !

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