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Caring for a

Gastrostomy Tube

A gastrostomy tube is a tube that is inserted


surgically via the abdomen into the stomach

It is used for patients requiring long-term


nutritional support

Special care is needed for the insertion site

Equipment

Disposable gloves

Washcloth, towel, and soap

Cotton tipped applicator

Sterile saline solution

Assessment

Assess the gastrostomy tube site, noting any


drainage, skin breakdown, or erythema

Check to ensure that the tube is securely stabilized


and has not become dislodged.

Assess the tension of the tube. If there is enough


tension, the tube may leak gastric drainage around
exit site.

If the tension is too great, the internal anchoring


device may erode through the skin

Nursing diagnosis

Imbalanced nutrition: less than body


requirement

Impaired skin integrity

Risk for infection

Deficient knowledge

Expected outcomes

The expected outcome to achieve when


caring for a gastrostomy tube is that the
patient ingests an adequate diet and
exhibits no signs and symptoms of irritation,
excoriation, or infection at the tube
insertion site.

In addition, the patient will be able to


verbalize the care needed for the
gastrostomy tube.

Action
1.

Explain procedure to patient

2.

Perform hand hygiene. Don disposable


gloves

3.

If the tube is new and still has sutures


holding it in place, dip cotton tipped
applicator into sterile saline solution and
gently clean around the insertion site,
removing any crust or drainage. If gastric
tube insertion site has healed and the
sutures are removed.

4.

Wet a washcloth and apply a small amount


of soap onto washcloth. Gently cleanse
around the insertion, removing any crust
or drainage. Rinse site, removing all soap.

5. Pat skin around insertion site dry


6. If the sutures have been removed, rotate
the guard or external bumper 90 degrees at
least once a day
7. Remove gloves and perform hand hygiene
8. Record care given, including appearance of
the site, any drainage present, and the
patients response

Unexpected situation and


associated interventions

Gastrostomy tube is leaking large amount of


drainage
Check the tension of tube.
If there is a large amount of slack between the
internal guard and the external bumper, drainage
can leak out the site.

Apply gentle pressure to tube while pressing the


external bumper closer to the skin.
If the tube has an internal balloon holding it in
place (similar to a urinary catheter balloon), check
to make sure that the balloon is inflated properly.

Skin irritation is noted around the insertion


site
If the skin is erythematous and appears to be
broken down, the culprit could be leakage of
gastric fluids from the site. Gastric fluids have a
low pH and are very acidic.
Stop the leakage, and apply a skin barrier

If the skin has patchy, redrash, the culprit could


be candidiasis (yeast). Notify the physician for an
order to apply an antifungal powder. Ensure that
the site is kept dry.
Site appears erythematous and patient complains
of pain at site. Notify physician; patient could be
developing cellulitis at the site.