GASTRIC GAVAGE regulate the drip or allow it

ASSESSMENT to run in over for 30min.

1. Assess the abdomen for distention, bowel iv. Add 30 - 60mL of water
sounds, firmness, or tenderness. If the when it is almost complete
abdomen is distended, measure the girth at the to allow it to run through.
umbilicus. v. Clamp the tubing
2. If the patient reports any tenderness or nausea, immediately after the water
or exhibits rigidity or firmness, confer with the has been instilled.
primary care provider administering the tube Disconnect the feeding
feeding. Assess the patient/family for the setup and clam the tube
rationale of the procedure and address any then cover it.
questions or concerns. Consult primary care b. When using a Large syringe.
provider for further explanation. i. Remove the plunger from
PLANNING 30 -60mL syringe.
1. Check the expiration date and discard if ii. Attach the syringe to the
expired. feeding tube then pour the
2. Powdered formulas should be used within pre measured amount of
24hrs of mixing. formula into the syringe.
3. Shake the container to mix it thoroughly. Regulate the rate by
4. The formula should be warmed to room changing the height of the
temperature before feeding. Cold formulas can syringe. Do not push with
increase the chance of diarrhea. Do not warm the syringe.
formulas in direct heat as it may cause it to iii. When the syringe has
curdle and hot formula can injure the patient. emptied, hold the syringe
IMPLEMENTATION high and disconnect from
1. Perform hand hygiene and put on PPE, if the tube. Clam the tube and
indicated. cover.
2. Identify the patient. c. When using an enteral feeding pump.
3. Explain the procedure to the patient and i. Close the flow regulator
answer questions. clamp and fill the feeding
4. Provide privacy and raise the bed to a bag with formula. Amount
comfortable working height. Perform key depends on facility policy.
abdominal assessments. Place a label on the
5. Gather equipment. Check amount, container with the patient’
concentration, type, and frequency of tube name, date, and time the
feeding in the medical record. Check formula feeding was hung.
expiration date. ii. Hang the container on the
6. Assemble equipment on table within reach. IV pole. Allow the solution
7. Assist the patient in a 30 - 45 degree position. to flow.
8. Put on gloves. Unpin the tube, verify the iii. Connect it to the pump, set
position of the marking, and measure the the rate. Maintain the
length of the exposed tube then compare it patient's upright position. If
with the documented length. the patient needs to lie
9. Attach a syringe to the end of the tube and temporarily, then pause the
aspirate a small amount of stomach contents. feeding. Resume the
10. Check pH feeding when the patient is
11. Check aspirated contents for color, and back in an upright position.
consistency. iv. Check for the placement of
12. If it is not possible to aspirate contents, the tube and for gastric
inconclusive tube placement assessments, tube residual every 4-6hrs.
length has changed, check placement by x-ray. 17. Observe the patient’s response during and after
13. After multiple steps to ensure the placement of the feeding and assess the abdomen.
the tube, return the residual based on facility 18. Have the patient remain in an upright position
policy. Proceed with the feeding if the residual for at least an hour after feeding.
does not exceed facility policy or the limit 19. Remove equipment and return the patient to a
indicated in the medical record. comfortable position. Remove gloves. Raise
14. Flush the tube with 30mL of water. Disconnect the side rails and lower the bed.
the syringe and cap the end of the tubing. 20. Put on gloves. Wash and clean the equipment
Remove gloves or replace according to facility policy. Remove
15. Put on gloves before preparing, assembling, gloves.
and handling any part of the system. 21. Remove additional PPE, if used. Perform hand
16. Administer feeding. hygiene.
a. When using a feeding bag EVALUATION
i. Label the bag or the tubing 1. Patient receives the ordered tube
with date and time. Hang feeding without complaints of
the bag on the IV pole and nausea, episodes of vomiting, gastric
adjust to about 12in above distension, or diarrhea.
the stomach. Clamp the 2. Patient demonstrates an increase in
tubing. weight.
ii. Check the expiration date 3. Patient remains free of any signs and
and clean the top with a symptoms of aspiration
disinfectant before opening 4. Patient voices knowledge related to
it. Pour the formula into the tube feeding.
bag and allow the solution
to run through. Close the
clamp.
iii. Attach the feeding setup,
open the clamp, and