1.護理方法
1.1.患者接受灌食時,應將患者床頭搖高約30度以上(無法坐臥者採右側臥式)。
1.2.每次灌食前先確定鼻胃管位置是否在胃內。檢視方法:
1.1.1.鼻胃管之刻度是否正確。
1.1.2.灌食空針反抽是否有內容物,如反抽無內容物,打30cc空氣至鼻胃管內,用聽診器可於胃上方聽到嘶嘶聲。
1.3.鼻胃管位置確定無誤後,以灌食空針抽20cc溫開水灌入胃中。
1.4.以灌食空針抽取食物或藥物,緩緩地灌入,灌食時空針應高於胃部。
1.5.待食物或藥物灌完後再抽20~30cc溫開水沖洗鼻胃管,以避免鼻胃管阻塞或食物殘留。
1.6.每一至二天更換固定鼻胃管的紙膠布,更換時將臉部皮膚拭淨再貼,並注意勿貼於同部位,及勿移動胃管所插入的深度。
1.7.灌食時若感覺不易灌入,可能是:
1.7.1.被食物或藥物阻塞:先用灌食空針反抽,再灌溫開水清洗鼻胃管。
1.7.2.鼻胃管前端黏於胃壁:可將胃管向外輕拉出約2公分,再回抽或灌空氣20~30cc,若灌通再予固定。
1.8.灌食完後,用具需洗淨並置於清潔容器內。
2.注意事項:胃灌食患者應每日給予口腔護理及鼻腔護理。
2.1.鼻胃管應避免受壓、扭曲或灌食時被拉出。
2.2.食物之溫度應維持溫熱(有特殊醫囑者例外),勿太冷或太燙,灌食速度宜緩慢。
2.3.灌食中及灌食完均應注意預防空氣進入。
2.4.使用氣管內管或氣切套管者,灌食前必先抽痰。
2.5.灌食過程中,若患者有異常情形,如:不停咳嗽、嘔吐、臉色發紫時,立即停止灌食,通知醫師並記錄之。
2.6.灌食量一次不得超過300cc,但若於灌食前反抽有多量未消化內容物,應將之再灌回,並減少流質灌食或停止灌食。
2.7.若患者連續兩次均出現反抽之胃內容物大於100~150ml,表消化情形不佳,應告知醫護人員處理。
2.8.管灌食物,請於4小時內灌畢,否則請置冷箱內以防食物腐壞。click here
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