Nasogastric and Gastrointestinal Intubations

A client’s condition may warrant special interventions to decompress the gastrointestinal tract. GI intubation is one of these interventions. Paralytic ileus is one of the conditions that would warrant intubation

Paralytic Ileus Etiology- Cessation of peristalsis resulting from: Neurogenic impairment Mechanical obstruction Direct irritation Pathophysiology- When peristalsis ceases, the stomach or small intestine (depending on location of problem or impairment) becomes distended from large quantities of air and fluid Signs and Symptoms- Abdominal distention, cessation of BMs, absent bowel sounds, vomiting

Purpose and Types of Tubes Nasogastric Tubes- Primarily inserted fo decompression of the stomach Types of tubes Levin Salem Sump Dobhoff or Duo

Purpose and Types of Tubes Intestinal Tubes- Long intestinal tubes serve several purposes: Decompression Splinting Determination of obstruction site Types of tubes Miller-Abbott Cantor

Measuring and Inserting an NG tube

Facilitating Tube Drainage Because gastric and intestinal fluid must move against gravity to be removed suction is required Low Suction High Suction Intermittent Suction Constant Suction Proper functioning

Prevention of Injury Anchoring the tube Pin tube

Prevention of Injury Prevent Oral Inflammations Keep oral membranes moist Use of ice chips Hard candy Prevent reflux and/or aspiration

Promotion of Comfort Removal of excess secretions Water soluble lubricant Relief for sore throat Warm saline gargles Ice bag to neck Prescribed throat lozenges Position changes

Specialty Tube Sengstaken- Blakemore Tube Used to control esophageal varices Multi-lumen tube with 2 balloons