This document discusses nursing care for patients with nasogastric tubes. It defines a nasogastric tube as a flexible tube inserted through the nose into the stomach. Indications for nasogastric tubes include gastric decompression and administration of medications or feeding. Complications include discomfort, epistaxis, and respiratory intubation. Nursing care involves checking tube placement, monitoring output, providing skin and mouth care, and documenting appropriately. The tube is removed by slowly withdrawing it from the stomach and then rapidly from the nose.

1. Nursing Care for
NasogastricTube Patients
‫إعداد‬
‫الرضا‬ ‫عبد‬ ‫فليح‬ ‫مصطفى‬
‫البالغين‬ ‫تمريض‬ ‫في‬ ‫علوم‬ ‫ماجستير‬
‫بغداد‬ ‫جامعة‬

2. Lecture Outline
• Definition
• Indications
• Contraindications
• Complications
• Placement of NG tube
• Inappropriate placement of NG tube
• Nursing Care and Maintenance
• Removing theTube

3. Nasogastric intubation
•Nasogastric intubation is a medical process
involving insertion of a flexible tube through the
nose into the stomach.

5. Indications
1. Diagnostic indications for NG intubation include the following:
• Evaluation of upper gastrointestinal (GI) bleeding (ie, presence,
volume)
• Aspiration of gastric fluid content
• Identification of the esophagus and stomach on a chest radiograph
• Administration of radiographic contrast to the GI tract

6. 2.Therapeutic indications for NG intubation include the following:
• Gastric decompression, including maintenance of a decompressed state
after endotracheal intubation, often via the oropharynx
• Relief of symptoms and bowel rest in the setting of small-bowel obstruction
• Aspiration of gastric content from recent ingestion of toxic material
• Administration of medication
• Feeding
• Bowel irrigation

7. Contraindications
• Maxillo – facial disorders, surgery orTrauma
• Oesophageal tumours, fistula or surgery
• Laryngectomy
• Skull fractures
• Head and neck surgery
• Tracheostomy (unless in ICU)
• Patient with a known coagulopathy is receiving anticoagulant medication,
or known to have oesophageal varices
• Alkaline ingestion

8. Complications
•Patient discomfort
•Epistaxis may be prevented by generously lubricating
the tube tip and using a gentle technique.
•Respiratory tree intubation
•Esophageal perforation

9. Placement of NG tube
• X-ray visualization of tube tip
• Measure exposed tube length
• Visual assessment of the color of the aspirate
• pH measurement of aspirate
• Air auscultation

10. Inappropriate placement of NG tube
• Decreased levels of consciousness
• Unable to speak
• Confused mental states, poor or absent cough and gag
reflexes, or agitation during insertion.
• The presence of an endotracheal tube or its recent removal
also increases the risk of inadvertent placement of the tube in
the lung

11. Nursing Care and Maintenance
• Nursing task basics: perform hand hygiene. Introduce self,
role, and purpose. Use at least two identifiers to confirm the
patient’s identity (wrist band and another). Perform the 6
rights of drug administration (Right patient, Right time, Right
order, Right dose, Right drug, Right Route and
documentation)

12. • Monitor drainage output, confirm that a x-ray was used for NG
placement, all ordered procedures, irrigation, how often to
preform suctioning. Care is typically performed every 4 hours or
less as needed
• Check tube placement for signs of migration: take note to where
it is marked on the patient and measure external tube length and
compare to what is documented in the chart
• Check tape and change as needed
• Use a penlight to assess skin and observe for signs of irritation
and redness
• Clean area around the tube every 4 hours

13. • Apply a lubricate around nose in order to maintain skin integrity
and reduce the risk of infection
• Frequent mouth care to keep the mucous membranes moist:
brush teeth every 8 hours (or use an oral care sponge) and offer lip
balm in order to maintain skin integrity and reduce the risk of
infection
• Report complaints and signs of nose or throat irritation (excessive
mucus, sore throat, or hoarseness).
• Document all nursing actions taken and the patient’s response to
intervention

14. Removing theTube
• Before removing a decompression tube, the nurse may intermittently clamp
it for a trial period of several hours to ensure that the patient does not
experience nausea, vomiting, or distention.
• Before any tube is removed, it is flushed with 10 mL of water or normal
saline to ensure that it is free of debris and away from the gastric lining.
• Gloves are worn when removing the tube.The tube is withdrawn gently and
slowly for 15 to 20 cm (6 to 8 in) until the tip reaches the esophagus; the
remainder is withdrawn rapidly from the nostril.
• If the tube does not come out easily, force should not be used, and the
problem should be reported to the physician.
• provides oral hygiene after the tube is removed.

15. Thank you for listening