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Mr. Abhay rajpoot
Nasogastric tube: A tube that is passed through the nose
and down through the nasopharynx and esophagus into
the stomach. It can be used to remove the contents of the
stomach, including air, to decompress the stomach, or to
remove small solid objects and fluid, such as poison,
from the stomach.
NG insertion is most commonly used for patients
who:
 Have neck or facial injuries
 Have had neck or facial surgery
 Need a mechanical ventilator to breathe
 Have an intestinal obstruction or blockage
 Short tubes: passed through the nose into the stomach:
range in size from 14 to 18 Fr, single lumen made of
plastic or rubber with holes near the tip.
 Medium Tubes: tubes are passed through the nose to
the duodenum and the jejunum.
 Long tubes: passed through the nose, through the
esophagus and stomach into the intestines. Used for
decompression of the intestines.
 To decompress the stomach and remove gas and fluid
 To lavage the stomach and remove ingested toxins
 To diagnose disorders of GI motility and other
disorders
 To administer medications and feedings
 To treat an obstruction
 To compress a bleeding site
 To aspirate gastric contents for analysis
Assessment:
− Who needs an NG:
 Surgical clients
 Ventilated client
 Neuromuscular impairment.
 Clients who are unable to maintain adequate oral
intake to meet metabolic demands.
− Assess patency of nares:
Assess client’s medical history:
 Nosebleeds
 Nasal surgery
 Deviated septum
 Anticoagulation therapy –
Assess client’s gag reflex. –
Assess client’s mental status. –
Assess bowel sounds-
Gather equipment:
 14 0r 16 Fr NG tube
 Lubricating jelly
 Flashlight
 Emesis basin
 Catheter tipped syringe
 50 ML syringe
 Bowl with water
 Stethoscope
 Explain procedure to client
 Position the client in a sitting or high fowlers
position.
 Examine feeding tube for flaws.
 Determine the length of tube to be inserted.
 Measure distance from the tip of the nose to the
earlobe and to the xyphoid process of the sternum.
 Prepare NG tube for insertion.
NG tube feeding can also potentially cause:
-Abdominal cramping
-Abdominal swelling
-Diarrhea
-Nausea
-Vomiting
-Regurgitation of food or medicine
Wash Hands
Put on clean gloves
Lubricate the tube
Hand the client a glass of water
Gently insert tube through nostril to back of throat
(posterior nasopharnyx). Aim back and down toward the
ear.
Have client flex head toward chest after tube has passed
through nasopharynx.
Emphasize the need to mouth breathe and swallow
during the procedure.
Swallowing facilitates the passage of the tube through
the oropharnyx.
 Advance tube each time client swallows until desired
length has been reached.
 Do not force tube.
 Check placement of the tube.
− X-ray confirmation
− Aspiration
NasogastricTube Position:
Observe client to determine response to procedure.
ALERTS!!! Persistent gagging
–Prolonged intubation and stimulation of the gag reflex
can result in vomiting and aspiration
−Coughing may indicate presence of tube in the
airway.
Note location of external site marking on the tube
 Documentation
− Size of tube, which nostril and client’s response.
− Record length of tube from the nostril to end of tube
 Identify signs and symptoms of inadvertent
respiratory migration.
 Identify conditions that increase the risk for
spontaneous tube dislocation from the intended
position (retching, vomiting, nasotracheal suctioning,
severe coughing) Enteral Nutrition.
 https://www.healthline.com/health/nasogastric-
intubation-and-feeding#purpose
 https://www.wikihow.com/Insert-a-Nasogastric-
(NG)-Tube
 https://www.wikihow.com/Insert-a-Nasogastric-
(NG)-Tube
 https://en.wikipedia.org/wiki/Nasogastric_intubation
 https://www.nursingtimes.net/clinical-
archive/gastroenterology/nasogastric-tubes-1-
insertion-technique-and-confirming-
position/5000781.article
Nasogastric tube (NG tube)

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Nasogastric tube (NG tube)

  • 2. Nasogastric tube: A tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach. It can be used to remove the contents of the stomach, including air, to decompress the stomach, or to remove small solid objects and fluid, such as poison, from the stomach.
  • 3. NG insertion is most commonly used for patients who:  Have neck or facial injuries  Have had neck or facial surgery  Need a mechanical ventilator to breathe  Have an intestinal obstruction or blockage
  • 4.  Short tubes: passed through the nose into the stomach: range in size from 14 to 18 Fr, single lumen made of plastic or rubber with holes near the tip.  Medium Tubes: tubes are passed through the nose to the duodenum and the jejunum.  Long tubes: passed through the nose, through the esophagus and stomach into the intestines. Used for decompression of the intestines.
  • 5.  To decompress the stomach and remove gas and fluid  To lavage the stomach and remove ingested toxins  To diagnose disorders of GI motility and other disorders  To administer medications and feedings  To treat an obstruction  To compress a bleeding site  To aspirate gastric contents for analysis
  • 6. Assessment: − Who needs an NG:  Surgical clients  Ventilated client  Neuromuscular impairment.  Clients who are unable to maintain adequate oral intake to meet metabolic demands.
  • 7. − Assess patency of nares: Assess client’s medical history:  Nosebleeds  Nasal surgery  Deviated septum  Anticoagulation therapy – Assess client’s gag reflex. – Assess client’s mental status. – Assess bowel sounds-
  • 8. Gather equipment:  14 0r 16 Fr NG tube  Lubricating jelly  Flashlight  Emesis basin  Catheter tipped syringe  50 ML syringe  Bowl with water  Stethoscope
  • 9.  Explain procedure to client  Position the client in a sitting or high fowlers position.  Examine feeding tube for flaws.  Determine the length of tube to be inserted.  Measure distance from the tip of the nose to the earlobe and to the xyphoid process of the sternum.  Prepare NG tube for insertion.
  • 10. NG tube feeding can also potentially cause: -Abdominal cramping -Abdominal swelling -Diarrhea -Nausea -Vomiting -Regurgitation of food or medicine
  • 11.
  • 12. Wash Hands Put on clean gloves Lubricate the tube Hand the client a glass of water Gently insert tube through nostril to back of throat (posterior nasopharnyx). Aim back and down toward the ear. Have client flex head toward chest after tube has passed through nasopharynx.
  • 13.
  • 14. Emphasize the need to mouth breathe and swallow during the procedure. Swallowing facilitates the passage of the tube through the oropharnyx.  Advance tube each time client swallows until desired length has been reached.  Do not force tube.  Check placement of the tube. − X-ray confirmation − Aspiration
  • 16. Observe client to determine response to procedure. ALERTS!!! Persistent gagging –Prolonged intubation and stimulation of the gag reflex can result in vomiting and aspiration −Coughing may indicate presence of tube in the airway. Note location of external site marking on the tube  Documentation − Size of tube, which nostril and client’s response. − Record length of tube from the nostril to end of tube
  • 17.  Identify signs and symptoms of inadvertent respiratory migration.  Identify conditions that increase the risk for spontaneous tube dislocation from the intended position (retching, vomiting, nasotracheal suctioning, severe coughing) Enteral Nutrition.
  • 18.  https://www.healthline.com/health/nasogastric- intubation-and-feeding#purpose  https://www.wikihow.com/Insert-a-Nasogastric- (NG)-Tube  https://www.wikihow.com/Insert-a-Nasogastric- (NG)-Tube  https://en.wikipedia.org/wiki/Nasogastric_intubation  https://www.nursingtimes.net/clinical- archive/gastroenterology/nasogastric-tubes-1- insertion-technique-and-confirming- position/5000781.article