(7) NasoGastric Tube (NGT).pptx

InsertionofSilasticNasogastricFeedingTube_HT_Arabic.pdf

1. Naso -gastric tube insertion & Feeding(NGT)

2. Inserting NGT:- Definition: Method of introducing a tube through nose into stomach. Definition: n aso -gastric tube feeding is a means of providing liquid nourishment through a tube into the intestinaL tract, when client is unable to take food or any nutrients orally.

3. Purpose: 1. To feed client with fluids when oral intake is not possible. 2. To dilute and remove consumed poison. 3. To instill ice cold solution to control gastric bleeding. 4. To prevent stress on operated site by decompressing stomach of secretions and gas. 5. To relieve vomiting and distention.

4. NGT

5. Equipments required 1. Nasogastric tube in appropriate size (1). 2. Syringe 10ml (1). 3. Lubricant. 4. Cotton balls. 5. Kidney tray (1). 6. Adhesive tape. 7. Stethoscope (1). 8. Clamp (1). 9. Marker pen (1). 10.Steel Tray (1). 11.Disposable gloves.

6. Procedure: 1. Check the indication for insertion of Naso -gastric tube. 2.Explain the procedure to the client. Explanation facilitates client cooperation. 3.Gather the equipments. Organization provides accurate skill performance. 4.Assess client’s abdomen. Assessment determines presence of bowel sounds and amount of abdominal distention. 5. Perform hand hygiene. Wear disposable gloves to protect from exposure to blood or body fluids.

7. 6.Assist the client to high fowler’s position, or 45 degrees, if unable to maintain upright position. Upright position is more natural for swallowing and protects against aspiration, if the client should vomit. 7. Checking the nostril: A) check the nares for patency by asking the client To occlude one nostril and breathe normally Through the other. B) clean the nares by using cotton balls. C) select the nostril through which air passes more easily. Tube passes more easily through the nostril with the largest opening.

8. 8. Measure the distance to insert the tube by Placing: A) place the tip of tube at client’s nostril extending to tip of earlobe. B) extend it to the tip of xiphoid process. C)mark tube with a marker pen or a piece of tape. 9. Lubricant the tip of the tube ( at least 1-2 inches) with a water soluble lubricant Lubricant reduces friction and facilitates passage of the tube into the stomach. Oxylocaine jelly may not be recommended to use as a lubricant due to the risk of oxylocaine shock. Water–soluble lubricant will not cause pneumonia if tube accidentally enters the lungs.

9. 10. Inserting the tube: Insert the tube into the nostril while directing The tube downward and backward. The client may gag when the tube reaches the Pharynx. Instruct the client to touch his chin to his chest. Encourage him/her to swallow even if no fluids are permitted. Advance the tube in a downward and backward direction when the client swallow. Stop when the client breathes If gagging and coughing persist, check placement of tube with a tongue depressor and flashlight if necessary. Keep advancing the tube until the marking or the tape marking is reached.

10. NB:- Do not use force. Rotate the tube if it meets resistance. Discontinue the procedure and remove the tube if the tube are signs of distress, such as gasping, coughing, cyanosis, and the inability to speak or hum.

11. 11.While keeping one hand on the tube, verify the tube’s placement in the stomach. a. Aspiration of a small amount of stomach contents: Attach the syringe to the end of the tube and aspirate small amount of stomach contents. Visualize aspirated contents, checking for color and consistency. b. Auscultation: Inject a small amount of air( 10- 15 ml) into the nasogastric tube while you listen with a stethoscope approximately 3 inches ( about 8cm) below the sternum. c. Obtain radiograph of placement of tube.

12. 12. Secure the tube with tape to the client’s nose. 13. Clamp the end of nasal-gastric tube while you bend the tube by fingers not to open Bending tube prevents the inducing of secretion 14. Putt off and dispose the gloves, Perform hand hygiene. 15. Replace and properly dispose of equipment. 16. Record the date and time, the size of the nasal-gastric tube, the amount and color of drainage aspirated and relevant client reactions. Documentation provides coordination of care. 17. Report to the senior staff.

13. NGT