Ateneo de Zamboanga University College of Nursing Report No.

7 NURSING SKILLS OUTPUT (NSO)

GASTROSTOMY I. DESCRIPTION: Gastrostomy feeding tube insertion is done in part using a procedure called endoscopy. For information on how this procedure is done. After the endoscopy tube is inserted, the skin over the left side of belly (abdomen) area is cleaned and numbed. The doctor makes a small surgical cut in this area and inserts a small, flexible, hollow tube with a balloon or special tip into the stomach. The doctor uses stitches to close the stomach around the tube.

II. MATERIALS AND EQUIPMENT NEEDED:

Gastrostomy tube Stomahasive wafer Surgical tools Clamp Sutures Catheter

III. PROCEDURE: 1. Ask consent from the patient. 2. Explain the procedure to the patient. 3. Place the patient into a comfortable position. 4. Assemble all necessary equipments needed for the procedure. 5. A local anesthetic may be sprayed into the patients mouth to prevent gag reflex 6. The abdomen of the client will be cleansed with aseptic solution 7. Local anaesthetic is used at the site of the incision area. 8. An incision about 3cm long is made in the upper abdomen near where the gastrostomy tube is to be placed 9. Once the stomach is visualized. Stitches are put in place to secure the stomach to the abdominal wall 10. A soft rubber tube is passed through the skin and into an opening made in the stomach 11. The tube is stitched in place 12. Then the incision is closed using dissolvable stitches under the skin

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IV. DIAGRAM:

V.NURSING RESPONSIBLITIES: BEFORE Obtain consent and make sure the client is informed or received an explanation about the procedure Obtain baseline data Assemble all the equipments needed Make sure there are no accessories that the patient is wearing Provide clean gown and let the patient change if necessary Provide privacy Assist in administering anesthesia Provide skin prep

DURING Reassure the client Drape the client Assist the client into an appropriate position Maintain sterility Handle instruments properly Pick up drop instruments and place on the tray Count the equipments before, during and after Provide after care Remove used linens Dispose used sutures,needles etc Assess the client for signs of infection and complications Document everything

AFTER

Additional Responsibilities: 1. Ensure procedure is carried out on correct client at correct site. 2. Reassure client to gain cooperation.
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3. Perform procedure in a correct manner to prevent complications. 4. Monitor client for intra and post procedure. 5. Ensure clients comfort is maintained throughout procedure. 6. Record findings and report abnormalities.

Reference/website:
Brunners and Suddart Medical surgical nursing 12th edition http://www.nlm.nih.gov/medlineplus/ency/article/002937.htm

Date

Clinical Instructors Initials

BSN III -

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