(5) While supporting the gastrostomy tube with one hand to prevent tension
on the tube, remove the old dressing. Inspect it for character, color, and odor of
drainage before discarding it into the paper bag.
(6)
Inspect the skin around the stoma (peristomal) for irritation or
breakdown.
(7) Wash the peristomal area with the washcloths and soap solution. Rinse
thoroughly and pat dry with a towel. Note any complaints from the patient of soreness
or tenderness in the peristomal area.
(8)
Apply a dry dressing. OpSite or sterile 4 x 4 gauze compresses may be
used.
NOTE:
If using gauze dressings, use surgical net or montgomery straps instead of
tape to secure the dressing. Frequent application and removal of tape will
cause skin breakdown.
(9) Coil the clamped end of the tube on the surface of the dressing. Be sure
there is no tension on the tube.
(10) Make the patient comfortable.
(11) Remove dressing equipment and discard waste. Wash hands.
(12) Record procedure, observations of skin condition, and patient tolerance
in the Nursing Notes.
1-42. GASTROSTOMY TUBE FEEDING
A gastrostomy tube feeding should be treated as a normal meal. The procedure
must never be rushed, and the atmosphere should be pleasant and relaxing for the
patient. The prescribed feeding may be a commercially prepared formula or a special
preparation from the hospital food service. The procedure for administration of a
gastrostomy tube feeding is as follows.
a. Review the patient's clinical record to verify physician's order for the amount
and type of tube feeding.
b. Wash your hands.
c. Collect the necessary supplies and equipment.
(1)
Feeding solution, as prescribed.
(2)
Large bulb syringe or catheter tip 50cc syringes.
MD0918
1-39