gastrostomy report
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Advantages of Gastrostomy
less time spent giving feeding
feeding can be done at night when child is
sleep
easily administered
provides an alternative route of feeding and
drug administration
decreases the risk of pulmonary aspiration
sure way of administering formula directly into the stomach
Disadvantages of Gastrostomy
leakage
risk of infection skin irritation
gastric distention
bleeding
Types of Gastrostomy
1. Stamm (Temporary and Permanent )
require either an upper abdominalmidline incision or a left upper quadranttransverse incision
requires the use of concentric pursestring sutures to secure a tube to theanterior gastric wall
an exit wound is created in the leftabdominal midline incision or a left upperabdomen to provide for the gastrostomy.
2. Janeway (Permanent)
require the same as stamm an upperabdominal midline incision or a left upperquadrant transverse incision
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necessitates the creation of a tunnel (called a gastric tube) that is brought outthrough the abdomen to form a permanent stoma
3. Percutaneous Endoscopic Gastostomy
is a procedure that requires the series oftwo physicians (or a physician and aspecially trained nurse)
the initial PEG device can be removedand replaced once the tract is wellestablished (1014 days afterinsertion)
4. LowProfile Gastrostomy Device (PGD)
may be inserted 36 months after initialgastrostomy tube placement
these devices are inserted flush with theskin; they eliminate the possibility of tubemigration and obstruction and haveantireflux valves to prevent gastric flux
Two types of devices may be used:
Obturated Devices (PEGButton orGastroPart II)
have done tip that acts as aninterval stabilizer
Nonobturated Devices (MIC - KEY)
has an external skin disk and isinserted into the stoma withoutforce; a balloon is inflated to secure placement
Types of Tube Feeding Methods
1. Bolus Tube Feedings
Allow introduction of 250 to 400 ml formula through the tube in a short period(usually 1530 minutes)
Administered by syringe or gravity flow system attached to the distal end of thefeeding tube
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2. Intermittent Tube Feeding
Allow delivery of between 250 and 400 ml formula are 306- minutes
Delivered by gravity flow system or an electric feeding pump
3. Continuous Tube Feeding
Allow formula to be administered at low ratesusually 1.5ml/min over a longertime (usually 1224 hours)
Delivered by gravity flow system or an electronic feeding
4. Cyclic Tube Feeding
Allow formula to be administered at lower ratesusually 1.5 ml/min over a longertime (usually 1224 hours)
Ensure adequate nutrition during weaning from tube to oral feeding
Alternate with oral food intake until client can take most nutrition orally
Types of Feeding Formula
1. Blenderized Formula
used infrequently, are more likely to clog feeding tube since they have a highviscosity
2. Commercially Prepared Polymeric Formula
contain unaltered molecules of proteins, carbohydrates and fats. They arebest for people who can digest and absorb nutrients without difficulty
are available as standard formulations containing protein isolate with one ormore sources of carbohydrates and fats.
3. Modular Formula is an incomplete liquid supplement that contains specific nutrients usually
single macronutrient.
4. Chemically Defined Formula
represent the ultimate reduction of food and have been called Space Diets
5. Disease Specific Formula
available to meet the needs of patients with specific medical problems, suchas glucose intolerance, liver disease, ling disease, GI dysfunction, renaldisease, etc.