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Clinical Hub,Patient Education,Health and Nutrition Facts For You,GI

Caring for Your J-tube (6102)

Caring for Your J-tube (6102) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, GI

6102

















Caring for Your J-tube




1
What is a Jejunostomy?

It is a procedure that creates a small hole through the abdomen into the small
intestine (jejunum). A thin tube placed through this hole, is called a J-tube. It
allows fluids, medicines, and feedings to be given directly into the small intestine.

Cleaning the J-tube Site

The J-tube needs to be cleaned daily to prevent infection. For the first 3 days after
the tube is placed, clean the skin around the tube with normal saline (see below) and
then let air dry. After 3 days, you may shower and let the water run over the skin
where the tube enters your body. If you can’t shower, keep cleaning with saline or
water and Q-tips using these steps.

1. Gather all supplies needed: 4x4 split gauze, tape, Q-tips , and normal saline

2. Wash hands well with soap and water for 30 seconds.

3. Open the sterile 4x4 split gauze and sterile Q-tips .

4. Remove the old dressing. Place the old dressing in a plastic bag and throw
away.

5. Check the skin around the tube for signs of infection. These may include
ξ The site is more tender and painful.
ξ Increased redness or swelling.
ξ Drainage that is green in color or foul smelling.
ξ Sutures (stitches) at the J-tube site that have come loose.

6. Clean the site with the sterile Q-tips and normal saline. Dry.

7. Place the sterile split 4x4 gauze dressing on the skin under the tube, tape in place

8. Secure the tube by taping it on your stomach. This helps prevent the tube from
being pulled out.


2

J-tube Feedings

What to Feed

Formula Name: _____________________________________________________
Name of Manufacturer: _______________________________________________
Name of Equivalent Products ___________________________________________
Total amount of formula per day ________________________________________
Total amount of water per day: _________________________________________
Additional
Vitamins/Minerals/Supplements: _______________________________________
Once opened, cans should be covered, dated, and refrigerated. If formula is not
used in 48 hours, throw it away.

When to Feed

Give _____________ cans/ml at ____________ ml ____________ times per day.

Flush the tube with ___________ ml of water promptly after each feeding is
complete.

When to Delay Feeding:

If you feel full, have nausea, or cannot flush your tube easily, try again in one hour.
If this does not help, call your doctor.

Supplies:

ξ Tube feeding formula
ξ 60 ml ENFit syringe
ξ Water for flushing before and after
feedings


ξ Pump stand or IV pole
ξ Feeding pump with feeding bag






3
Starting the Tube Feeds Why

1. Wash hands with soap and warm
water for 30 seconds.

2. Flush the tube with 30ml tap water.

3. New feeding should be given at
room temperature.

4. Fill feeding bag with formula.

5. Remove air from tubing by
unclamping the tube and letting the
formula fill the tubing. When it
reaches the end of the tubing,
reclamp. Put the tubing into the
pump.

6. Connect the tubing to your J-tube
and pump.

7. Start the pump and check the rate.

8. Do not lie flat during the feeding or
for one hour after. Use a couple of
pillows to keep your head up at least
30 degrees.

9. When feeding is done, flush the
tube with 30ml of tap water, as
soon as feeding is complete.

10. Clean your supplies by rinsing the
syringe and bag with cool water.
Then swish with warm water and a
small amount of liquid dishwashing
soap. Rinse well. Hang to dry.
Replace the feeding bag every 3 days
and the syringe once a week.
Helps prevent infection.

Flushing before feeding helps to make
sure tube is open and working.

Cold feedings can cause intestinal
cramps.



Prevents extra air from entering the
intestine while feeding.










Prevents feedings from being inhaled
into your lungs.



Prevents clogged tubes.



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5
Giving Medicines

Only liquid medicines can be placed through your J-tube. Flush the tube with
30 ml of water before and after giving the medicine.

1. Use the plunger syringe and draw back at least 30 ml of water. This is the
“flushing stage”. Keep in mind you must flush the J-tube before and after
giving any medicines.
2. Turn the OFF position (if you are receiving tube feeds, if you are not
connected to tube feeds it should be in the off position)
3. While holding the ACE Connector ® firmly push and twist the plunger syringe
into the Auto-Seal Port until tight



4. Flush the J-tube with the 30 ml of water
5. Remove the syringe. The Auto-Seal Syringe Port will close and no fluid or
medication will leak out
6. Next draw up the liquid medication you will be giving. If the medication is
thick you may want to add at least 10ml of water to it to make it easier to give.
7. Again, attach the syringe with the medication in it to the Auto-Seal Port and
give the medication
8. Remove the syringe and fill it with another 30 ml of warm water. This water
will be used to flush the medication through the J-tube.
9. If there is more medicine to give than the plunger syringe can hold you may
repeat steps 3-8 as needed.
10. If you are receiving tube feeds, make sure you put the handle back into the ON
position and restart your tube feeds.
11. If you are not receiving tube feeds then leave the handle in the off position

Congratulations! You are done!



6

Common Problems

1. Blocked tube
2. Excessive leakage around the tube
3. Redness around the tube
4. Bleeding around tube
5. Stitches come loose or tube falls
out
6. Tube is punctured or torn
7. Some bleeding
8. Vomiting
9. Diarrhea
10. Dehydration
11. Constipation

1. Blocked tube

 Gently flush the tube using 15 ml of warm water. You may need to flush
and pull out the water many times until the tube will flush. Prevent
blockage by always flushing tube with 30 ml water after feedings, before
and after medicines. If you cannot unclog your tube, call your doctor.

2. Excessive leakage around the tube

 Call your nurse or doctor.

3. Redness around the tube

 Keep the skin around the tube clean and dry. (Some redness is normal, but
moisture can irritate the skin and lead to an infection.)
 Clean the skin around the site more often using plain water (Soap may cause
further skin irritation).
 Keep red areas open to air.
 Ask a nurse about other ways to hold the tube in place.
 Call the nurse or doctor if you see signs of infection (redness, swelling,
rash, greenish drainage).

4. Bleeding around the tube

 If you notice more than a few drops of blood, call your doctor or nurse.
 Keep the tube taped or secured tightly to your skin to prevent pulls that
might cause injury.




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5. Stitches come loose or tube falls out

 If the tube falls out partly, or all the way, do not try to push it back in. If
you can, secure the tube with tape.
 Call your doctor right away or go to the closest ER. You will need to have
the tube changed or replaced.

6. Tube is punctured or torn

 Clamp the tube (or seal with tape), close to your skin. Call your doctor right
away or go to the closest ER.

7. Noticing Blood

 If you cough up blood, or see 50 cent-size blood clots coming from the J- tube,
or see blood in your stool, call your doctor.

8. Vomiting

 Because vomiting causes the loss of body fluids, salts, and nutrients in the
body, call your doctor or nurse if it doesn’t stop.
 Do feedings in an upright position with the head of the bed raised 45
degrees.
 Try smaller feedings more often. Make sure total amount for the day is the
same. The type of the formula may need to be changed.
 Infection may cause you to vomit. Be sure supplies are cleaned well and
rinsed between feedings. Wash your hands after contact with persons who
are ill. This helps prevent the spread of infection.
 Other causes might include food intolerance, side effects of medicine, too
much formula at one time.

9. Diarrhea

 Diarrhea means frequent, loose, watery stools. Looser stools may be
normal with certain types of formula. A few loose stools in a 24-hour
period are not a problem.
 There are many causes of diarrhea when on tube feeding. To avoid some of
these problems:
1. Do not hang feedings for longer than 8 hours.
2. Give the tube feeding more slowly.
3. If the diarrhea does not stop after 2 or 3 days, call your doctor.



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10. Dehydration

Vomiting, diarrhea, fever, and sweating cause the body to lose fluid. You may
no longer feel thirsty so you must be very careful to note the signs of
dehydration. If you have any symptoms listed below, call your doctor to find
out how much and what kind of extra fluid to give at these times.

 Decreased urine or darker colored urine
 Crying with no tears
 Dry skin that has no recoil when squeezed
 Fatigue or irritability
 Weight loss
 Feeling dizzy
 Dry mouth and lips
 Sunken eyes
 Headache

11. Constipation

 Constipation may be due to lack of fluids, lack of fiber in the diet or a side
effect of medicine.
 This is common in the elderly or those who are less active.
 If you have chronic constipation, call your nurse or doctor, they may have
you give extra water or change your formula. (Always check with your
doctor before giving extra water.)

Common Questions and Answers

Are there things I should keep in mind when I travel?

Take pack all the supplies needed for feeding: pump, pole, syringe, formula,
tubing, bottled water, tape, etc. Opened formula can be stored in a cooler in the
summer to prevent spoilage. A small canvas bag that is always filled with
supplies needed for travel may be helpful.

Can I sleep on my stomach?

Yes. After the tube site has healed, most people are quite comfortable on their
stomachs. You should not sleep on your stomach during a feeding or within 1
hour after the feeding.



9

You will receive supplies for the feedings and care for the J tube through the
hospital or home care. It depends on the situation and doctor’s orders. You will
need to contact the Home Health agency for more supplies when you are at home.

Phone Numbers

Please call if you have concerns or questions.

Doctor: Phone Number: ______________
Local Doctor: Phone Number: ____________
Nurse: Phone Number: ______________
Dietician: Phone Number: ______________
Vendor: Phone Number: ______________

















Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 6/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF6102.