3. Nasogastric Tube
P u r p o s e
A t u b e p a s s e d t h r o u g h t h e n o s e d o w n t h r o u g h t h e
n a s o p h a r y n x a n d e s o p h a g u s i n t o t h e s t o m a c h .
F o r d e c o m p r e s s i o n , t o r e m o v e t h e c o n t e n t s o f t h e
s t o m a c h ( a i r , p o i s o n , s m a l l s o l i d o b j e c t s a n d
f l u i d ;
D i a g n o s t i c s : c h e c k G I m o t i l i t y ; g a s t r i c c o n t e n t
a n a l y s i s ;
A d m i n i s t e r m e d i c a t i o n s a n d f e e d i n g s
4. Other indications
N e c k a n d f a c i a l i n j u r i e s
N e c k a n d f a c i a l s u r g e r y
O n M e c h a n i c a l V e n t i l a t o r
W i t h G I s y s t e m / i n t e s t i n a l o b s t r u c t i o n
M e t a b o l i c N e e d s
U s e d f o r p a t i e n t s w i t h :
1 .
2 .
3 .
4 .
5 .
5. L O W C O S T
S A F E
T O L E R A N C E O F
P A T I E N T S
E A S I E R T O U S E B Y
E X T E N D E D C A R E
F A C I L I T I E S
NGT
ADVANTAGES
6. TUBE TYPES
S H O R T T U B E S : F r . 1 4 - 1 8 , s i n g l e l u m e n , p l a s t i c /
s i l i c o n e r u b b e r
M E D I U M T U B E S : p a s s e d t h r o u g h t h e n o s e t o t h e
d u o d e n u m a n d j e j u n u m
L O N G T U B E S : p a s s e d t h r o u g h t h e n o s e ,
e s o p h a g u s , s t o m a c h a n d i n t o t h e i n t e s t i n e .
U s e d t o d e c o m p r e s s t h e i n t e s t i n e s
7. SHORT TUBE: LEVINE TUBE
Fr. 14-18, single lumen, plastic / silicone rubber
13. Nursing Assessment
3. Tube Placement- auscultating the gastric
area with a stethoscope to detect air
(gurgling sound when air is introduced in
the tube using an asepto syringe).
*not a reliable indicator.
CONFIRMATORY: X-ray (tip have reached the
stomach rather than the esophagus)
17. Nursing Responsibilities
Infection control - replace opened
formulas q 4hrs
Tube change q 4 weeks or as needed
Check gastric residue pre-feed (if on
cont feeding, check q4 hrs. If residue is
<100, cont feeding, but hold if >100cc
Record I&O, weekly weight, dietary
consult
1.
2.
3.
4.
20. 1.Check doctor’s order for formula, rate,
frequency of feeding and expiration date of
formula.
EX: 1200KCAL OTF IN 6 DIVIDED FEEDINGS
2.Prepare tube feeding at room temperature.
3.Gather all necessary equipment and
supplies.
STEPS
PREPARATION
21. 4.Identify client and explanation the
procedure.
5. Place client to high fowler’s position in bed
or to a sitting position in a chair unless
contraindicated.
6. Perform medical hand washing; wear clean
gloves and other appropriate infection control
measures.
7.Place towel over the patient’s chest.
IMPLEMENTATION
22. Check for tube placement and patency by doing any of
the following:
a. Introduce 5-20 ml of air into Nasogastric Tube (NGT)
and auscultate at the epigastric area
GOOD SIGN: GURGLING SOUND
b. Aspirate gastric content.
GOOD SIGN: yellowish, whitish color and less than 100cc
c. Immerse tip of the tube in the glass of water
GOOD SIGN: no bubbles produced.
ASSESSMENT
23. 9. Flush 30 ml of water into the NGT.
10. Infuse feeding through the subsequent steps:
a. Pinch/Kink proximal end of the feeding tube
b. Attach syringe to the NGT
c. Fill the syringe with measured amount of
formula
d. Release the tube and hold the syringe at 12
inches above the client. Refill; repeat until the
prescribed amount has been given.
11. Irrigate/flush 30 ml of water into the NGT after
the feeding.
FEEDING
24. 12. Clamp NGT before all of the water is instilled.
13. Ask client to remain in Fowler’s position 30
minutes to one hour after feeding
14. Do after- care.
15. Discard gloves and perform medical hand
washing.
16.Evaluate client’s tolerance and response to
feeding: complaints of nausea and vomiting
17. Documentation: amount, type, time; client's
response
POST-FEEDING
