The use of a gastronomy tube (G-tube)
Week 5 Discussion Forum
Prompt 1
The use of a gastronomy tube (G-tube) to give patient nutrition was a good treatment approach. Gastronomy tubes are life-saving because they are used when the patient has difficulties in getting nutrition through the mouth (Kak et al. 2017). Hence, it was prudent for the physician to use a gastronomy tube to save the life of the patient. One pro of the feeding tubes is that they improve nutrition. Feeding tubes are used to give nutrients to the patient in liquid form with the motive of enhancing the nutritional support of the patient’s body, and this minimizes cases of choking. Another pro is that feeding tubes enhance growth and development. If the patient has feeding complications, the use of feeding tubes helps them to get sufficient calories that are responsible for improving the level of energy in the body, enhancing body strength and ultimately fostering growth and development of the patient.
However, feeding tubes do have their cons, and this may include increased chances of infection and suffering to the patient. Boag (2018), states that feeding tubes may cause frequent pains, rashes, swelling and the patient’s skin may become red. Another con is that the tubes may clog and therefore hinder the delivery of nutrients to the patient, and the patient may develop complications like dehydration. One behavior modification technique I would use as a follow-up for the treatment would be flushing the tube so as to ensure that it does not get clogged. Clean water can be used to do the flushing. Another behavior modification would be training the family members in charge of the patient on checking the level of water in the balloon to ensure that the tube is steadfast. Family members may develop stress and depression when one of their family members has a feeding problem. Therefore, I would offer cognitive therapy to the family members to help them develop coping skills that would minimize stress. One of the coping skill would be regular exercise.
Prompt 2
Enteral nutrition refers to feeding mechanisms that employ the gastrointestinal tract to give calories to an individual. Examples of enteral nutrition include oral diet and liquid supplements. Parenteral nutrition is the process through which calories are delivered to an individual’s body through the veins. In enteral feeding, nutrients are administered using the gastrointestinal tract, while in parenteral nutrition, an individual gets nutrients via the intravenous routes. Enteral feeding contains calories that range from 1 to 2 kilos per millilitre while parenteral nutrition has calories that range from 25 to 30 kilos in each kilogram in a given day (Reignier et al. 2018). Additionally, the indication for enteral nutrition is after 5 to 7 days when the individual is not able to consume anything orally, whereas, parenteral nutrition is indicated in the absence of enteral nutrition and when the patient has gone for between 5 to 7 days without consuming anything (Reignier et al. 2018).
The implications of enteral nutrition include pulmonary aspiration. Henry (2017), states that pulmonary aspiration may result in case the patient had been diagnosed with a stroke, presence of high boluses and increased gastric volume in the body. To minimize severe consequences, nurses should keep on tracking the gastric residual volume probably after every four hours. Patients may also experience imbalanced levels of body fluids like water. Lack of water balance may result in dehydration. Nurses should flush the feeding tubes with the required fluids at specific times to prevent overloading of fluids. One of the implications of parenteral nutrition is clogging of the feeding tubes, and nurses are highly concerned because it may hinder the delivery of nutrients in the body. Clogging may be handled through continuous flushing of the tube. Another parenteral implication is breakage of the tube, and this issue can be fixed through replacement. Nurses are highly concerned with breakage because the tube may break when the patient urgently deserves to be fed.
References
Kak, M., Issa, N. P., Roos, R. P., Sweitzer, B. J., Gottlieb, O., Guralnick, A., … & Rezania, K. (2017). Gastrostomy tube placement is safe in advanced amyotrophic lateral sclerosis. Neurological research, 39(1), 16-22.
Boag, A. (2018, April). Feeding tubes for the general practitioner: when, why and how?. In BSAVA Congress Proceedings 2018 (pp. 394-395). BSAVA Library.
Reignier, J., Boisramé-Helms, J., Brisard, L., Lascarrou, J. B., Hssain, A. A., Anguel, N., … & Botoc, V. (2018). Enteral versus parenteral early nutrition in ventilated adults with shock: a randomized, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). The Lancet, 391(10116), 133-143.
Henry, B. (2017). Evolving ethical and legal implications for feeding at the end of life. Ann Palliat Med, 6(1), 87-90.