Question

Stage 3: Your daughter is now 6 years old and is coming in for a MicKey GT for supplemental feedings overnight to help increase her weight gain. She has become a bit more independent with her ostomy and is able to help with emptying the bag into the toilet. She no longer pulls at the bag or wafer but has a nice cover over it to “keep her friend warm” and calls it her poop collector friend. We have told her that she is getting a feeding friend to keep the poop collector friend company as she tends to get lonely when she is in school. Your nurse needs to provide preop education and preop teaching about surgery and what to expect after surgery, as she will be going to surgery this afternoon. She is very hungry and keeps asking you why she cannot eat or drink anything. You also need education on the Mickey, care of the tube, and tube feeding. Your other questions are below:

1. How long in surgery? ___________________________________________________________________

2. What should we expect after surgery? __________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________

3. How will I know if she is in pain? __________________________________________________________ __________________________________________________________________________________________________________________________________________________________________________

4. How do I take care of the tube and when do I give her the feeding? ______________________________ __________________________________________________________________________________________________________________________________________________________________________

5. Can she still eat dinner with the family? ____________________________________________________ _____________________________________________________________________________________

6. I am concerned about her social life as she doesn’t have too many friends. She plays with the dog a lot. Are friends important or can she play with our dog? What can I do to help her social life?

_____________________________________________________________________________________________________________________________________________________________________

Answer 1

Q1

Answer: The surgery for the G tube placement is about 30 to 40 minutes long.

Q2

The expectation after the surgery is that the child will complain of pain in the incision part and she cannot take food orally for a period of time around. The patient should hydrate by using IV fluid infusion.

Q3

Answer: The presence of pain can be identified by observing the facial expression and verbalization of pain by the patient. Facial pain scales also can be used to identify the level of pain.

Q4

Answer: The feeding can be started from the day after the surgery. The tube should be flush with warm water 10-15 cc to prevent the block of the tube. A clear liquid diet should be given first. Maintain proper hygiene to prevent infection and observe the surrounding for any sign of infection.

Q5

Answer: She can eat with the family if she is able to tolerate it. First, start with liquid only. A hard diet should be avoided.

Q 6

Answer: It is ok to play with the dog but she should be careful that the tube should not dislodge. Advice the parent to accept what is going through. Advice the child to start interacting with others, tell them to accept what she is going through. The parent can help the child to enrolled in children club so that she can mingle with many friends.