Gastrostomy Feeding Button Care

  • Is used as alternative feeding device for an ambulatory patient receiving a long term enteral feedings.
  • It’s approved for 6-month implantation and can replace gastrostomy tubes.
  • The button is inserted into an established stoma and lies almost flush with skin; only the top of the safety plug is visible.
  • Advantages over ordinary feeding tubes include cosmetic, appeal, ease of maintenance, reduced skin irrigation and breakdown, and less chance of being dislodged or migrating.
  • The button has a one-way antireflux valve inside a mushroom dome that prevents leakage of gastric contents; its usually replaced every 3 to 4 months, typically because the antireflux valve wears out.

Contraindications

  • Intestinal obstruction that prohibits use of the bowel
  • Diffuse peritonitis
  • Intractable vomiting
  • Paralytic ileus
  • Severe diarrhea
  • Use cautiously in patients with severe pancreatitis, enterocutaneous fistulae, and GI ischemia.

Equipment

  • Gastrostomy feeding button of correct size
  • Obturator
  • Water-soluble lubricant
  • Gloves
  • Feeding accessories
  • Catheter clamp
  • Cleaning equipment
  • I,V pole and pump

Procedure

  1. Reinforce the explanation of the insertion, reinsertion, and feeding procedure to the patient.
  2. Verify the patient’s identity using two patient identifiers, such as the patient’s name and identification number.
  3. Make sure signed consent has been obtained.

Providing feedings through the feeding button

  1. Wash hands and put on gloves; monitor the patient’s bowel sounds, if absent, withhold the feeding and notify the physician.
  2. Attach the adapter and feeding catheter to the syringe
  3. Clamp the catheter and fill the syringe or bag catheter with formula.
  4. Open the safety plug and attach the adapter and feeding catheter to the button.
  5. Elevate the syringe or feeding bag above stomach level, and gravity-feed the formula for 15 to 30 minutes, varying the height as needed to alter the infusion rate.
  6. Use an administration pump for a continuous infusion or for feedings lasting several hours.
  7. Refill the syringe before it’s empty to prevent air from entering the stomach and distending the abdomen.
  8. After the feeding, flush the button with 10ml of water.
  9. Lower the syringe or bag below stomach level to allow burping.
  10. Remove the adapter and feeding catheter.
  11. Snap the safety plug in place to keep the lumen clean and prevent leakage if the antireflux valve fails.
  12. Wash the catheter and syringe or feeding bag in warm, soapy water and rinse thoroughly.
  13. Clean the catheter and adapter with a pipe cleaner.
  14. Rinse well before using for the next feeding.
  15. Soak the equipment weekly.

Nursing Interventions

  1. Keep an extra feeding button at the bedside.
  2. Once daily, clean the peristomal skin with mild soap and water or providone iodine.
  3. Clean the peristomal site whenever the feeding bag is spilled.
  4. Reinforce with the patient how the gastrostomy feeding button is inserted and cared for.
  5. Remind the patient how to use the button for feedings.
  6. Reinforce how to clean the equipment and provide peristomal skin care.

Complications

  • Nausea and vomiting, abdominal distention, exit-site infection, exit-site leakage, and peritonitis.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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