Indications for PEG Tube Placement
PEG tubes are typically indicated for patients with conditions such as: Dysphagia (difficulty swallowing)
Neurological disorders (e.g., stroke, ALS, Parkinson's disease)
Head and neck cancers
Severe malnutrition or chronic illness
Procedure for PEG Tube Placement
The placement is usually performed by a gastroenterologist using an
endoscope. The patient is sedated, and the endoscope is passed through the mouth into the stomach. A small incision is made in the abdominal wall, and the PEG tube is inserted.
Nursing Care for PEG Tube
Initial Post-Procedure Care
After placement, it is crucial to monitor the patient for complications such as infection, bleeding, or tube dislodgement. Nurses should:
Inspect the insertion site for signs of
infection (redness, swelling, discharge)
Check for proper tube placement and securement
Assess for abdominal pain or discomfort
Daily Care and Maintenance
Daily care includes:
Cleansing the insertion site with mild soap and water
Rotating the tube daily to prevent skin irritation
Flushing the tube with water before and after feedings to maintain patency
Monitoring for signs of tube blockage or dislodgement
Feeding and Medication Administration
Nutrition and medication administration via PEG tube require careful planning and monitoring: Ensure the patient is in an upright position during and after feedings to prevent aspiration
Use appropriate formulas as prescribed by a dietitian
Administer medications in liquid form when possible, or crush tablets and mix with water
Potential Complications
Complications can arise and should be promptly addressed: Infection at the insertion site
Tube dislodgement or blockage
Gastroesophageal reflux or aspiration
Granulation tissue formation around the site
It is essential to educate patients and caregivers on recognizing and managing these complications.
Patient and Family Education
Effective education is crucial for successful home care: Teach proper tube care and feeding techniques
Provide written instructions and demonstrations
Emphasize the importance of hand hygiene
Discuss signs of complications and when to seek medical help
Conclusion
PEG tubes are vital for patients who cannot meet their nutritional needs orally. Nurses play an essential role in the initial care, daily maintenance, feeding, and patient education. Understanding the procedure, indications, and potential complications helps ensure optimal patient outcomes.
