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Lavage - Nursing Care Gastrointestinal and Urinary Systems

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all air. Attach the adapter at the end of the tubing to the nasogastric tube. Place a chux
pad under this connection.
(5)  Adjust the flow rate to deliver the required number of ml per minute.
This can be done by adjusting the clamp located below the drip chamber. If precise
control of feeding is required, the feeding may be controlled by use of an infusion pump
such as IMED or IVAC. If pump control is not used, the patient must be observed at
frequent intervals during feeding to prevent the feeding from being administered too
quickly.
(6)  When the required feeding has been administered, clamp the feeding
tube and disconnect it from the nasogastric tube.
(7)  Clear the nasogastric tube of feeding residue by instilling 30-50 ml of
plain water. Clamp the tube.
(8)  Record the type and amount of feeding, along with the amount of water
given, on the I&O worksheet.
(9)
Record the procedure and the patient's tolerance in the nursing notes.
(10) Dispose of used equipment properly. Local Department of Nursing
policy will specify the length of time a feeding set may be used before being exchanged.
1-38. LAVAGE
a. Introduction. Gastric lavage is the washing out of the stomach via a
nasogastric tube or stomach tube. Lavage is ordered to wash out the stomach (after
ingestion of poison or an overdose of medication, for example) or to control
gastrointestinal bleeding. If the patient does not have a nasogastric tube in place
already, the physician will order the insertion of the appropriate tube. For a stomach
wash, the physician will probably order the insertion of an Ewald stomach tube or a
large lumen nasogastric tube. To control gastrointestinal bleeding, a large lumen
Levine tube or Salem sump tube will be inserted. In the event of severe bleeding, as in
the case of esophageal varices, a Sengstaken-Blakemore tube will be inserted. A large
lumen tube is preferred, since particles of food or other material may occlude the lumen
of a small tube. The tube must be checked to verify proper placement in the stomach
prior to proceeding with lavage.
b. Equipment. Gather the following equipment and take to the patient's
bedside.
(1)
Syringes, 2 or more, 50cc catheter tip.
(2)
Washbasins, 2 (to collect used solution).
MD0918
1-33



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