Gastrostomy (PEG Tube)
Surgical opening through the abdominal wall into the stomach for feeding
Definition
A gastrostomy is a surgical opening through the abdominal wall into the stomach, typically for long-term enteral feeding. The most common type is the percutaneous endoscopic gastrostomy (PEG) tube, placed endoscopically.
Indications
- Dysphagia (stroke, ALS, head/neck cancer)
- Prolonged mechanical ventilation
- Failure to thrive
- Severe cognitive impairment with aspiration risk
Nursing Care
- Monitor site for infection (redness, drainage, pain)
- Clean site daily with soap and water; rotate tube slightly to prevent adhesion
- Verify placement before each feeding (residuals, gastric pH)
- Elevate HOB 30 to 45° during and 60 minutes after feedings
- Flush with 30 mL water before/after feedings and medications
- Give medications in liquid form when possible; crush tablets if allowed
- Monitor for dislodgement. If tube falls out, cover site and notify provider within 30 minutes (can close rapidly)
NCLEX Relevance
HOB elevation, placement verification, and skin care around the site.