Assisting in Nasogastric Tube Insertion 1 1
Assisting in Nasogastric Tube Insertion 1 1
Assisting in Nasogastric Tube Insertion 1 1
NASOGASTRIC TUBE
INSERTION
BY: MARISSE C. ARROYO, RN, MN
DEFINITION
■ Nasogastric Tube (NGT) – a flexible tube
made of rubber or plastic that is inserted
through one of the nostrils down the
nasopharynx and esophagus down into
the alimentary tract.
■ In some instances, the tube is passed
through the mouth and pharynx,
although this route may be more
uncomfortable for the adult client and
may cause gagging.
■ Nasoenteric Tube – a longer tube (at
least 40 inches for an adult) inserted
through one nostril down into the upper
small intestine.
RATIONALE EQUIPMENT
■ Hypoallergenic tape
■ Water-soluble lubricant
■ To administer tube feedings and
medications to clients who are ■ Glass of water and drinking straw basin pH chemstrip
comatose, semiconscious, or
unable to consume sufficient ■ Stethoscope
nutrition orally. ■ Penlight
■ To establish a means for ■ NGT Fr 14 or 16 (depending on the size of the person)
suctioning stomach contents to
prevent gastric distention, nausea, ■ Guidewire or Stylet for small-bore tube
and vomiting.
■ Solution basin filled with warm water (if plastic tube is
■ To obtain gastric specimens for used) or Ice (if rubber tube is used)
analysis.
■ To lavage (wash) the stomach in
■ 20 – 50 ml syringe with an adapter or Asepto Syringe with
case of oral ingestion of poisonous small-bore tube
substance or overdose of ■ Clean gloves
medications.
■ Tissues and towel
■ Suction apparatus if required
Type of NGT
PLANNING AND IMPLEMENTATION
ACTION IMPLEMENTATION
1. Review client’s medical record • To confirms doctors order for inserting a nasogastric
and history. tube; history of nasal or sinus surgery or problem.
2. Gather the equipment. • To facilitate an efficient procedure.
3. Wash hands. • To prevent the spread of microorganisms.
4. Check client’s armband; • To verify correct client; explanation of procedure
explain procedure, showing reduces anxiety and increases client cooperation.
items.
5. Raise the bed the bed and place • To facilitate passage of the tube into the esophagus
it in a high Fowlers position (45 to and swallowing.
60 °) or assist the client to a
Fowlers position, at least a 45°
angle or higher, with a pillow
behind client’s shoulder; provide
for privacy.
■ Place comatose clients in semi-
Fowler’s position.
PLANNING AND IMPLEMENTATION
ACTION RATIONALE
6. Place towel over patient’s chest, with • To prevents soiling of gown and bedding and protects
tissues in reach. Don clean gloves. nurse from contamination with bodily fluids; lacrimation
can occur during insertion through nasal passages.
7. Examine nostrils with penlight and assess
as client breathes through each nostril. • To determine the most patent nostril to facilitate insertion.
15. Connect the distal end of the tube to • To establish an appropriate pathway for intervention.
suction, draining bag, or adapter according
to the purpose of this nursing intervention.
17. Instruct client about movements that can • To reduce anxiety and to teach client how to
dislodge the tube. prevent tugging on tube with head
movement.
18. Gastric decompression:
■ Remove syringe from free end of the tube, and
connect tube to suction tubing; set machine on • To perform decompression as prescribed by
type of suction and pressure as prescribed. the doctor; intermittent or continuous
suctioning is determined by type of tube
■ Levine tubes are connected to intermittent low inserted.
pressure.
■ Salem sump or Anderson tube is connected to
continuous low suction.
■ Observe nature and amount of gastric tube or
drainage.
■ Assess client for nausea, vomiting, and • To provides information about patency of
abdominal distention. tube and gastric contents.
PLANNING AND IMPLEMENTATION
ACTION RATIONALE
19. Provide oral hygiene and cleanse nares with a • To promote comfort.
tissue.
• To prevent the spread of microorganisms;
20. Remove gloves, dispose of contaminated materials protect other workers from coming into contact
in proper container, and wash hands/hand hygiene. with objects contaminated with body fluids.
21. Position client for comfort, and place call light • To promote comfort and safety.
within easy reach.
VARIATION:
INSERTING A NASO-INTESTINAL TUBE: