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Andrew Pollack-Gray

Nursing Notes

Care of Residents With Medical Tubing

4 min read

Patient Needs

Some residents rely on medical tubing to deliver fluids, medications, or supplemental oxygen.
The CNA helps maintain comfort, mobility, safety, and proper positioning while protecting the equipment from accidental disruption.

What Should I Assess?

Intravenous (IV) Therapy

  • Tubing pulling or becoming caught during movement.
  • Redness, swelling, leakage, or bleeding at the IV site.
  • Complaints of pain or discomfort.
  • IV equipment interfering with transfers or dressing.

Supplemental Oxygen

  • Acute conditions:
    • Asthma attack, trauma.
    • Highly concentrated
  • Chronic conditions:
    • COPD or Emphysema
    • Oxygen typically between 1-6 L/min
  • Nasal cannula or mask position.
  • Visible damage, disconnections, or kinks.
  • Dryness, irritation, or bleeding around the nose.
  • Skin redness or breakdown behind the ears.
  • Changes in breathing effort or respiratory distress.
  • Ensure flow rate is alongisde resident’s care plan, and adequate amount of oxygen is in portable tank.

Enteral Feeding Tubes (Gastrostomy & Nasogastric)

  • Visible pulling, kinks, displacement, or accidental disconnection.
  • Redness, swelling, leakage, drainage, or irritation near a gastrostomy insertion site.
  • Discomfort, coughing, gagging, vomiting, or breathing difficulty.
  • Tubing that interferes with positioning, transfers, or hygiene.
  • Residents will be in Fowler’s position at all time.

Report concerning findings promptly. Do not independently assess internal tube placement.

How Do I Provide Care?

Supporting Residents With IV Tubing

  • Keep the IV pole and tubing safely positioned during movement.
  • Prevent pulling during transfers, ambulation, and dressing.
  • Use appropriate gowns or clothing accommodations.
  • Follow the nurse’s instructions when changing clothing around IV equipment.
  • Report IV site concerns promptly.
  • Do not disconnect, adjust, or manipulate an IV infusion outside authorized duties.

Supporting Residents Receiving Oxygen

  • Confirm equipment and prescribed setup against the care plan, within assigned responsibilities.
  • Check for visibly displaced or kinked tubing.
  • Ensure tubing does not create a tripping hazard.
  • Observe breathing comfort and skin condition.
  • Follow approved procedures for portable oxygen equipment.
  • Encourage a comfortable position that supports breathing.
  • Reinforce coughing, deep breathing, or incentive spirometry instructions already taught by the nurse when directed.

Supporting Residents With Feeding Tubes

  • Protect tubing from accidental pulling during bathing, dressing, positioning, and transfers.
  • Follow the resident’s individualized positioning and aspiration precautions.
  • Observe the visible insertion site and surrounding skin during routine care as appropriate.
  • Provide routine hygiene within assigned duties.
  • Request nursing assistance for suspected tube displacement, leakage, blockage, or equipment problems.
  • Do not independently insert, reposition, flush, or administer feeding, water, or medication through a feeding tube.
  • Do not attempt to restart feeding equipment or determine tube placement independently.

Safety & Precautions

Oxygen Safety

  • Oxygen supports combustion.
  • Keep oxygen equipment away from smoking, flames, sparks, and heat sources.
  • Follow oxygen equipment safety rules.
  • Never change a prescribed oxygen flow rate independently.
  • Do not assume all residents require the same flow rate.
  • Follow the care plan for oxygen-related skin protection.

IV Safety

  • Do not alter IV pump settings or infusion rates.
  • Avoid disconnecting IV tubing.
  • Prevent tension on vascular access devices.
  • Seek nursing assistance before transfers if equipment management is uncertain.

What Should I Report?

  • New or worsening shortness of breath.
  • Chest pain or severe respiratory distress.
  • Oxygen equipment problems or discrepancies.
  • IV site redness, swelling, bleeding, or pain.
  • Accidental dislodgement or suspected device failure.
  • Skin breakdown associated with tubing.
    Emergency: Severe respiratory distress or sudden deterioration requires immediate escalation.

Sources

Flashcards

What must a CNA not independently change on oxygen equipment?03-application / patient-care
Answer

The prescribed oxygen flow rate.

What signs at an IV site must be reported?03-application / patient-care
Answer

Redness, swelling, leakage, bleeding, or pain.

What should a CNA do if a resident's feeding tube appears displaced?03-application / patient-care
Answer

Stop potentially disruptive care, protect the tubing, and notify the nurse promptly.

May a CNA independently administer formula, water, or medications through a feeding tube?03-application / patient-care
Answer

No. Refer feeding-tube administration to authorized clinical personnel.

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