1. Naso-gastric tube insertion involves passing a tube through the nose and into the stomach to provide liquid nutrition or remove gastric contents when oral intake is not possible. 2. The procedure requires various equipment including a naso-gastric tube, syringe, lubricant, and stethoscope. The client is positioned upright and the tube is measured and marked for insertion. 3. After lubricating the tip of the tube, it is slowly inserted through the nose while the client swallows. Placement is verified by aspirating stomach contents or injecting air and listening with a stethoscope. The tube is then secured and the client monitored.

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

2. Inserting NGT:-
Definition:
Method of introducing a tube through nose into
stomach.
Definition:
naso-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