2) With an ileus or obstruction, the body is not receiving any nutrition from the gastric contents. Anything put into the stomach will just sit there and add to the accumulation (and discomfort). 1) The gut is still not functioning enough to move gastric contents from the stomach through the bowel. Now think about this: do you replace what the suction has pulled off? IF the NG is placed to relieve N/V, abdominal distention, due to obstruction or ileus, at least in our facility, the residuals are measured and discarded. The sole purpose of NG to suction is to empty the stomach. Once suction is pulling off a minimal amount, the MD will usually order the NG to be capped and residuals checked Q4. You hook the NG up to suction and empty the gastric contents to relieve the pressure, nausea & vomiting. The body is continuing to produce fluids that are building up in the stomach, causing nausea, vomiting and severe discomfort. If you place a NG due to bowel obstruction or ileus, the gastric contents are not moving through the gut. If things are only coming out, leave it out. In this case, the residuals also determine the timing and volume of the next TF.Ī good rule of thumb for checking/returning residuals is, if something's going back in, put it back. Rather than removing bilious, acidic fluids that the body produces in response to an empty belly, the gastric contents in a patient on a TF have nutrients and electrolytes needed by the body. That's because not returning them could result in an electrolyte or pH imbalance. We DO RETURN residuals when checking someone who's on a tube feed. Returning the residuals would add to the volume of fluid building up in the stomach. The reason behind it is that it's just sitting there, it's not going anywhere on its own, and the body continues to produce fluids that are being backed up by a bowel obstruction or ileus. In our hospital, when checking residuals through a NG on someone who's been hooked up to suction, we don't return the residuals. As always, FIRST check your facility's policy.
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