Q: Is it okay for a nurse to replace a gastrostomy tube?

A: Carol McGinnis, RN, MS, CNSC, replies:

Replacing a gastrostomy tube is within the scope of practice of registered nurses on a state-specific basis. Thus, it is important to review your state’s nurse practice act in this regard. Gastrostomy tube replacement requires a medical order as well as training beyond what is typically offered in basic nursing programs. This education should be consistent with established institutional protocols and may involve demonstration of competency in performance of the procedure.

PEG (percutaneous endoscopic gastrostomy) tubes are one type of gastrostomy tube. Other gastrostomy tubes may be placed surgically by using an open incision or laparoscope or by using fluoroscopy. Of course, not all gastrostomy tubes themselves are alike. For example, some tubes have an internal balloon that can become accidentally deflated or can be intentionally deflated for removal. Other tubes...

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