Rt insertion

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Rt insertion

  1. 1. RYLES TUBEINSERTIONwww.drjayeshpatidar.blogspot.com
  2. 2. R.T.INSERTIONDEFINITION: - NASOGASTRIC TUBEINSERTION MEANS THEINTRODUCTION OF A TUBE INTO THESTOMACH FOR THERAPEUTIC ORDIAGNOSTIC PURPOSES.GASTRIC GAVAGE – IS A ARTIFICIALMETHOD OF GIVING FLUID ANDNUTRIENT THROUGH A TUBE, THATHAS PASSED THROUGH THE NOSE.www.drjayeshpatidar.blogspot.in
  3. 3. INDICATION – PERFORMING A GAVAGE – FOR ARTIFICIALFEEDING THE PATIENT ADMINISTRATION OF ORAL MEDICATIONS THATCANNOT BE SWALLOWED. ASPIRATION OF GASTRIC CONTENT (LAVAGE) –FLUID, FOOD, OR GAS. TO CORRECT FLUID AND ELECTROLYTEIMBALANCE. ALLEVIATES DISCOMFORT DUE TONAUSEA, VOMITING & REDUCES THE POSSIBILITYOF ASPIRATION OBTAINING A SAMPLE OF SECRETION FORDIAGNOSTIC TESTING. CONTROLLING GASTRIC BLEEDING A PROCESSCALLED COMPRESSION. ON TAMPONADE (PRESSURE)www.drjayeshpatidar.blogspot.in
  4. 4. EQUIPMENT: - NASOGASTRIC TUBE (E.G. LEVIN, SALEM) 14, OR 16FT. NG TUBE SYRINGE WATER SOLUBLE LUBRICANT TOWEL EMESIS BASIN STETHOSCOPE GLASS OF WATER CLEAN GLOVE FLASHLIGHT TAPE SCISSOR BOWEL WITH WATERwww.drjayeshpatidar.blogspot.in
  5. 5. PREPARATION OF PATIENT— EXPLAIN THE PROCEDURE TO THE PATIENT ANDASK FOR PATIENT’S CO-OPERATION PROVIDE PRIVACY PLACE THE PATIENT IN FOWLER’S POSITION,MAKE THE PATIENT COMFORTABLE PLACE MACKINTOSH AND TOWEL ACROSS THECHEST AND UNDER THE CHIN GIVE A MOUTH WASH AND HELP HIM TO CLEANTHE TEETH. CLEAN THE NOSTRILS, IF THERE IS SECRETION ORCRUST FORMATION, USING SWAB STICK DIPPEDIN SALINE OR SODA BICARB SOLUTION.www.drjayeshpatidar.blogspot.in
  6. 6. PREPARATION OF UNIT—ARRANGE THE ARTICLESCONVENIENTLY ON THE BEDSIDELOCKER. ROOM SHOULD BE WELL VENTILATED SEND VISITORS AWAY FROM THE ROOMwww.drjayeshpatidar.blogspot.in
  7. 7. www.drjayeshpatidar.blogspot.in
  8. 8. www.drjayeshpatidar.blogspot.in
  9. 9. www.drjayeshpatidar.blogspot.in
  10. 10. www.drjayeshpatidar.blogspot.in
  11. 11. PROCEDURESTEPS RATIONALEWASH HANDS ELEVATE HEAD ENDOF BED TO 45º ANGLEPLACE THE TOWELOVER CLIENTS CHESTAND EMESIS BASINWITH IN REACHTO PREVENT CROSSINFECTIONHEAD ELEVATIONPROMOTES SAFETY DURINGTUBE INSERTION.CLIENT MAY EXPERIENCEDISCOMFORT OR MAY GAGOR VOMIT DURING TUBEINSERTION. AND AVOIDSOILING OF CLOTHESwww.drjayeshpatidar.blogspot.in
  12. 12. STEPS RATIONALEINSPECT CLIENTS NOSETO DETERMINE LENGTH OFTUBE TO BE INSERTED,MEASURE FROM TIP OFCLIENTS NOSE TO EARLOBEAND FROM EARLOBE TOXIPHOID PROESS OFSTERNUM MARKDETERMINED DISTANCE ONTUBE WITH TAPE OR PEN.CHECK FOR NASALINFECTION OR ANYDEVIATION.THIS LENGTHSHOULD BESUFFICIENT TOADVANCE TUBE INTOCLIENT’S STOMACH.www.drjayeshpatidar.blogspot.in
  13. 13. STEPS RATIONALELUBRICATE THE 6 TO 8INCH OF TUBE WITHWATER SOLUBLELUBRICANTSWITH CLIENTS HEADUPRIGHT OR SLIGHTLYEXTENDED, CAREFULLYINSERT TUBE INTOCLIENTS NOSTRIL AIM ITTOWARDS CLIENT’S EARAND DOWNWARD ANDGENTLY ADVANCE ITTOWARDS CLIENT’SNOSOPHARYNXTHIS FACILITITATESADVANCEMENTTHROUGH NASALPASSAGE, AND PREVENTSDAMAGE TO MUCOSATURNING ANDDIRECTING TUBE, ITCONFORMS TO ANATOMICPASSAGEWORK WHENTUBE REACHESNASOPHARUNXRESISTANCE WILL BEFELT.www.drjayeshpatidar.blogspot.in
  14. 14. STEPS RATIONALEHAVE CLIENT OPENMOUTH AND CHECKWITH LIGHT TOVISUALIZE TUBE.ENCOURAGE CLIENT TOSWALLOW.TO VERIFY THAT TUBEIS AT BACK OF THROAT,AND NOT COILED UP INMOUTH.ADVANCE TUBE ASCLIENT SWALLOWS.SWALLOWING OPENSUPPER ESOPHAGEALSPHINCTER AND ALLOWSTUBE TO ENTERESOPHAGUS.www.drjayeshpatidar.blogspot.in
  15. 15. STEPS RATIONALEONCE TUBE IS ADVANCEDTOWARD BACK OF THROAT,HAVE CLIENT FLEX HEADFORWARD, THEN ROTATETUBE 180ºINWARD.ASPIRATE 20 TO 30 ML OFAIR INTO SYRINGE, ATTACHSYRINGE TO FREE END OFNASOGASTRIC TUBE, TOCHECK FOR TUBE POSITIONTHIS HELPS DIRECTTUBE PASTNASOPHANYNXTUBE MUST BEPLACED IN CLIENT’SALIMENTARY CANALNOT RESPIRATORYTRACT.www.drjayeshpatidar.blogspot.in
  16. 16. STEPS RATIONALEPLACE STETHOSCOPEOVER CLIENT’SEPIGASTRIC REGION,THEN INJECT AIR ANDTHEN LISTEN FORSWOOSHING SOUND.AUSCULTATION IS NOLONGER. CONSIDERED ARELIABLE METHOD FORVERIFICATION OF TUBEPLACEMENT.THIS INDICATETHAT TUBE HASPROBABLY REACHEDSTOMACHTUBEINADVERTENTLYPLACED IN THELUNGS, PHARYNX, ORESOPHAGUS CANTRANSMIT A SOUNDSIMILAR TO THATENTERING THESTOMACH.www.drjayeshpatidar.blogspot.in
  17. 17. STEPS RATIONALEKEEPING SYRINGEATTACHED, PULLBACK ON PLUNGERTO ASPIRATE GASTRICCONTENT. CHECK FORCOLOR AND PH OFCONTENTS.WRAP THESECURING TAPEAROUNDNASOGASTIC TUBE.SECRETION MAY BEOBTAINED FROM TUBEINADVERTENTLY PLACEDIN CLIENT’S AIRWAY ORPLEURAL SPACE PHTESTING OF ASPIRATEDSECRETION HELPSDETERMINE WHERE TUBEHAS BEEN PLACED.TO STABILIZE TUBEwww.drjayeshpatidar.blogspot.in
  18. 18. STEPS RATIONALEPIN TAPE OR RUBBERBAND TO CLIENT’SGOWN TO SECURE TUBEABOVE CLIENT’SSTOMACH. PLUG END OF TUBE,OR CONNECT END OFTUBE TO INTERMITTED/CONTINUOUS SUCTIONDEVICEIF THE TUBE ISPULLED TENSIONWILL BE PLACED ATPINNED SITE RATHERTHAN CLIENTS NAIRS.FORDECOMPRESSION.www.drjayeshpatidar.blogspot.in
  19. 19. RECORDING AND REPORTINGRECORD AND REPORT TYPE AND SIZE OFTUBE PLACED, CLIENTS TOLERANCE OFPROCEDURE CONFIRMATION OF TUBEPOSITION BY X- RAY.CHECKING PLACEMENT –ASPIRATION FLUID – ASPIRATED FLUIDAPPEARS CLEAR, BROWNISH – YELLOWON GREEN.www.drjayeshpatidar.blogspot.in
  20. 20. AUSCULTATION OF ABDOMEN – NURSE IINSTILLS 10 ML OF AIR WHILE LISTENINGWITH THE STETHOSCOPE OVER THEABDOMEN, IF A SWOOSHING SOUND ISHEARD THE NURSE CAN REFER THAT ITWAS CAUSED BY THE AIR ENTERING THESTOMACH. BLEACHING OFTEN INDICATESTHAT THE TIP IS STILL IN THE ESOPHAGUSCONTINUES BUBBLE SHOWS PLACEMENTOF TUBE IN LUNGSwww.drjayeshpatidar.blogspot.in
  21. 21. TESTING PH OF ASPIRATED FLUIDASPIRATE SMALL VOLUME OF FLUID FROMTHE TUBE WITH A CLEAN SYRINGEDROP A SAMPLE OF GASTRIC FLUID ONTOAN INDICATION STRIP. COLOUR OF TEST STRIP CHANGESACCORDING TO THE HYDROGEN IONCONCENTRATION OF LIQUID . STOMACHFLUID USUALLY HAS PH OF 1 – 3 ACIDIC IFPH 5 TO 6 , PATIENT RECEIVINGMEDICATION TO DECREASE GARTNICACIDITY OF FLUID MAY BE FROMDUODENUM PH OF 7, OR GREATERINDICATES THAT TUBE IS IN RESPIRATORYTRACT.www.drjayeshpatidar.blogspot.in
  22. 22. Thank youwww.drjayeshpatidar.blogspot.in

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