Nurses Education

FEEDING BY GASTROSTOMY TUBE  Sometimes a surgeon performs gastrostomy operation for feeding a patient in cases of operation over oesophagus or soft palate or tumour or structure in oesophagus.in such cases it becomes the prime duty of the nurse to feed the patient carefully through the gastrostomy tube.the tube is inserted through an opening in abdominal wall going in to the stomach by piercing stomach wall.the Cather or tube is usually a self retaini g one known as "De Pezzer Catheter".the tube is taken out periodically and replaced by a new one. For the first few days it is important to observe the sliping out the tube from the incision in which case it should be replaced immediately otherwise it will be very difficult to introduce the tube and the purpose of the operation becomes defeated. EQUIPMENT REQUIRED *Funnel. *Piece of tubing. *Tubing clip *Connector *A catheter *Makintosh *Sterilized dressing and bandage *Bowl of water *A tray containing a

APPARATUS REQUIRED FOR TUBE FEEDING For mouth wash or tray for cleaning mouth if the tube is required t pass through mouth Sodabicarb swabs for cleaning nostrils if tube is required to pass by nasal route. A small glass or polythene funnel. An oesophageal tube size 6 to 18 english guaze or 14-22 (french guaze).the larger size are used for oral route and smaller size for nasal route. A tray or bowel for keeping all apparatus. A measure containing water to clear the tube.  A container with feed. A location thermometer. Adhesive tape. Towel a piece of makintosh,tongue forcep,tongue spatula. Mouth gag,if necessary. Lubricant soloution for tube (liquid paraffin). A 50 ml syringe. Emesis basin to collect if vomiting occurs. PROCEDURE Intimate the patient about the procedure. He should be told: The reason for procedure. Approximately how long it will take. What it will feel like. How he can co-operate better.screen the patient for privacy.    https://nurseducat

Tube feeding or lavage may be oral or nasal.When the tube in passed through mouth,it is known as oral lavage and when it is passed through nose when mouth poses problem,it is known as nasal lavage.     CONDITION FOR TUBE FEEDING *Comatose patient. *Paralysis of soft palate or pharyngeal muscle in diphtheria or other such condition. *After operation over mouth,pharynx or larynx. *For premature or weak infants who are unable to suck. *In case of intensity when patients always refuses to take food. https://nurseducation2020.blogspot.com/2020/02/diet-and-feeding-sick.html PRINCIPLES OF TUBE FEEDING Utmost care should be taken to ensure that the tube is in stomach neither in lungs or nor coiled in mouth or pharynx.It is better to check the position of the tube by a second nurse or by a doctor. Air shoud not be allowed to enter stomach while the feed is being given.So the apparatus should not be allowed to be empty until entire feed has been exhausted. To avoid discomfort

INjuries  and operationsin and arround mouth may pose problem for feeding.under such condition feeding is managed as follows.                           https://nurseducation2020.blogspot.com/2020/02/diet-and-feeding-sick.html HARELIP DEFORMITY Small infant with congenital harelip deformity may be able to take food without posing problem.But if complete cleft palate is present,the infant may need spoon feeding or feeding by naso gastric tube,for spoon feeding the infant is laid flat on the lap of nurse or mother and fed by means of spoon to the back of the mouth.In post operative cases of harelip or cleft palate spoon feeding is continued using a small narrow spoon which will not stretch the mouth.Water is given before and after each food.Crying causes stretching of stitches or may cause removal,so cry for feed should be avoided if sufficient amount of feed is given and repeated before the infant cries for feed.      CLEFT PALATE  Harelip is operated early but cleft