A small compilation of nurse anesthesia care plans
These anesthesia care plans are meant to inspire nurse anesthesia residents when they are making their care plans. Always make sure you fully understand and "own" your care plan. Your plan must be specific for your patient and should always be with the most up-to-date information.
Gastrostomy Tube Placement
Overview
Surgical placement of a tube through the abdominal wall for gastric decompression and nutritional support. It can be permanent or temporary.
Patients may be neurologically incapacitated and likely to have compromised control of their airway reflexes. This places them at greater risk for aspiration.
Stamm gastrostomy
Placed at the time of a laparotomy performed for another purpose. Incision over the stomach and use of purse-string sutures mark the intended site of entry into the stomach and are tied securely once the G-tube is in place.
Percutaneous endoscopic gastrostomy
The gastrostomy tube is introduced through the mouth and passes through the stomach and abdominal wall from inside out.
Preoperative Considerations
Position
Supine
Incision
Puncture or midline/transverse – need endoscope for PEG
Antibiotics
Cefazolin 25mg/kg for peds or per MD
Surgical Time
0.5-1hr
EBL
Minimal
Morbidity
Wound infection, hemorrhage, aspiration pneumonia, failure to function
Anesthetic considerations
NPO for procedure
IV access
Shared airway
Decreased FRC with supine position
Risk for aspiration
- May have to empty stomach first
Risk of injury to internal organs
- Monitor hemodynamics