NASOGASTRIC TUBE INSERTION.pdf

this is how to utilization ng tube nursing students

1. NASOGASTRIC TUBE INSERTION
By AYALEW K.
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2. What is nasogastric tube insertion? What is nasogastric tube insertion?
✓Inserting the plastic tube through the nose, down
the esophagus, and into the stomach
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3. ✓used for diagnostic, therapeutic, preventative, and feeding
purposes.
✓It provide for analysis purpose of GI contents.
✓To remove stomach contents after suspected poisoning
✓To wash the stomach after suspected poisoning
✓To relieve vomiting and distention
✓To administer medications who cannot swallow.
✓To feed client with fluids when oral intake is not possible
Purpose/Indication:
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4. Before inserting the tube
1
•Inform to the patient about the
procedure
2
•Position the patient (Semi flower)
3
•Measure the tube.
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5. ✓By placing tip of the tube on the patient's nose and
touches the tip of the xiphoid process.
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6. After inserted check the tube in stomach or not
1.Auscultation
✓instillingairintothefeedingtubewitha
syringeandplacedastethoscopeoverthe
stomachtolistenforrushingair.
✓Misinterpretation of auscultation of air
insufflation is known as pseudo-confirmatory
gurgling.
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7. 2. Bubbling
✓Observing bubbles when the end of the feeding
tube is placed under water.
✓Also, the absence of bubbles does not rule out
respiratory placement if the tube’s ports are
occluded by the respiratory mucosa.
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8. 3. Aspirate Appearance
✓assessing the appearance of aspirate from the tube.
Ordinarily,
–Small bowel aspirates are golden yellow or greenish brown
–Gastric aspirates are often grassy green, off-white, or tan.
–Respiratory secretions can be white, yellow, straw-colored
✓Because both respiratory and gastrointestinal
aspirates may be similar in color, they may be easily
misinterpreted.
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9. 4. PH Testing
✓Determining the pH of aspirated gastric fluid
usually acidic, with a pH less than or equal to
5.5.
✓Respiratory secretions are almost always
alkaline, with a pH greater than or equal to 6.
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10. 5. Radiographic
✓The gold standard for nasogastric feeding
tube placement is radiographic confirmation
with a chest x-ray.
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11. Size of NG-Tube based on age
Infant = 5-8 Fr.
Child = 8-10 Fr.
Adult = 8-18 Fr.
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12. Intubation the client with an NG tube
•Assessment:
1-patency of the nostril
2-swallowing reflex
3-the ability of the client to cooperative
–Assess client’s medical history:
•Nosebleeds
•Nasal surgery
•Deviated septum
•Anticoagulation therapy
–Assess client’s gag reflex.
–Assess client’s mental status.
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13. Equipment:
✓-Trolleyisclean
✓--NGtube
✓-Glassofwater
✓-Lubricatingjelly
✓PHteststrips
✓Emesisbasin
✓stethoscope
✓syringe-50cc-
✓Suctioningavailableandready
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14. ✓Explain the procedure to the client
✓Position the client in a sitting or high fowlers
position. If comatose-semi fowlers.
✓Determine the length of tube to be inserted.
✓Measure distance from the tip of the nose to the
earlobe and to the xyphoidprocess of the sternum.
✓Prepare NG tube for insertion.
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15. Fowler's Position. Used to
promote drainage or ease
breathing. Head rest is adjusted to
desired height and bed is raised
slightly under patient's knees
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17. Implementation
1-Wash Hands
2-Put on clean gloves
3-Lubricate the tube
4-Hand the client a glass of water
5-Gently insert tube through nostril to back of throat
(posterior nasopharynx).
6-Emphasize the need to mouth breathe and swallow during the
procedure.
7-Swallowing facilitates the passage of the tube through the
oropharynx.
8-Advance tube each time client swallows until desired length has
been reached.
9-Do not force tube. If resistance is met or client starts to cough,
choke or become cyanotic stop advancing the tube and pull back.
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19. 11-Check placement of the tube.
-By Auscultation
-X-ray confirmation
-aspiration for gastric content
12-Secure the tube with tape .
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21. Nasogastric Tube Position
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22. Complications
•Nose bleeding
•Nasal irritation
•Sinusitis
•Sore throat
•Esophageal perforation
•Pulmonary aspiration
•Electrolyte imbalance: hyperkalemiaand
hypernatremia
•Oral mucosal breakdown
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