Jejunostomy
Surgical opening into the jejunum for enteral feeding
Definition
A jejunostomy (J-tube) is a surgically placed feeding tube that enters the jejunum (middle portion of the small intestine), bypassing the stomach. It is used for patients at high risk of aspiration or when gastric emptying is impaired.
Indications
- Severe gastroparesis
- Recurrent aspiration
- Gastric outlet obstruction
- Gastric cancer or resection
- Severe GERD
Feeding Considerations
Feedings MUST be continuous (not bolus) due to small volume capacity of jejunum. Bolus feeding can cause dumping syndrome. Rapid fluid shifts, abdominal pain, diarrhea. Use isotonic formulas.
Nursing Care
- Monitor site for infection, skin breakdown
- Assess for clogging; flush with water regularly
- Elevate HOB 30°
- Do not administer crushed pills that clog small-lumen tubes
- Monitor for diarrhea, cramping (common with J-tube feeds)
NCLEX Relevance
J-tube = continuous feeding only; bolus risks dumping.