Week 6 | Tubes and Drains (17170-SP)

Healthcare professional working on tube.

Content Outline

  • Indications 
    • Remove fluid for decompression  
    • Remove fluid or drainage from wound or cavity 
    • Prevent infection 
    • Instill antibiotic fluids 
  • Types of Tubes 
    • Gastrostomy and jejunostomy tubes-inserted percutaneously through the abdomen can be placed by surgery, endoscope, laparoscopic, or radiologic techniques. 
      • Gastrostomy Tube Held in place with an internal and external retention device. It should rest snugly to prevent migration of tube and potential leakage of gastric contents. If gastrostomy tube with a balloon, check the balloon volume every 7 to 10 days. Consult the manufacturer's literature to determine balloon volume. An external retention disk or bumper secures the device to the abdomen. 
      • Jejunostomy Tube-Appropriate for patients with gastric disease, upper GI obstruction, and absent gag reflex (reducing the risk of aspiration). Held in place with an internal and external retention device it should rest snugly to prevent migration of tube and potential leakage of gastric contents.  
      • Low-profile gastrostomy devices-Usually placed into a mature gastrostomy tract it is anchored in the stomach and protrudes just above the skin. Available with a firm internal bumper or with a balloon-style internal bumper that is inflated after insertion. An antireflux valve keeps gastric contents from leaking onto the skin. It is less likely to irritate surrounding skin. 
  • Securing the Tube 
  • Skin Care 
    • Inspect the skin around the tube site daily for signs of skin breakdown, infection, tenderness, or excoriation.  
    • Look for the cause of a leak rather than simply patching up the area with a new dressing. 
  • Complications  
    • Skin breakdown around the tube insertion site  
    • Tube displacement  
    • Tube occlusion 
    • Peristomal hyperplasia 
    • Fungal infection 
    • Poor tube placement 

Objectives for Learning Outcomes

At the end of this course work the learner will be able to:

  1. Describe the features of, stabilization and skin care for common percutaneous tubes and drains. 

  2. Describe the assessment and management of common complications of tube and drains. 

Additional Information

Format: 
Video
Course summary
Available: 
01/13/2017
Expires: 
04/30/2018

Donna Rydberg, MSN, RN, CWOCN
Northwest WOC Consultants Inc., Certified Wound Ostomy Continence Nurse

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