Nasogastric Tube Feeding It is a type of enteral feeding which is used as an alternative feeding method to ensure adequate nutrition and

it is also used for gastric decompression through the use of a nasogastric tube. Purposes of NGT 1. To provide feeding (gastric gavage). 2. To irrigate stomach (gastric gavage). 3. For decompression (drainage of gastric content). 4. To administer medications. 5. To administer supplemental fluids. Indication of NGT 1. To clients who are unable to eat by mouth or swallow a sufficient diet without aspirating food or fluids into the lungs. 2. Those who can not tolerate sufficient amount of fluids needed for their care. 3. Those that need gastric drainage. Nursing Responsibilities Before and During Insertion 1. Check the doctors order. To be safe or out of any legal issues. 2. Inform the patient and explain the procedure. To allay anxiety. 3. Wash hands. To prevent infection. 4. Assess the clients nares. To check which nares is the best for insertion. 5. Prepare equipment. 6. Place in high-fowlers position. To facilitate insertion of NGT. 7. Measure the length of NGT to be inserted (tip of the nose to the tip of the ear lobe to the xiphoid process=50cm.) NEX technique. This length approximates the distance from the nares to the stomach. 8. Lubricate tip of the tube with water-soluble lubricant. To reduce friction. Do not use oil because it may cause lipoid pneumonia. 9. Hyperextend the neck, gently advance the tube toward the nasopharynx. For easier passage of the tube.

10.Tilt the patients head forward once the tube reaches the throat and ask to swallow, as the tube is advanced. To facilitate or to help in the insertion of the tube. 11.Secure the tube. To prevent the tube from being dislodge or pulled out. 12.Document the procedure. To inform the other members of the health care team. Nursing Responsibilities During Administering Tube Feeding 1. Assist client to a semi-Fowlers position in bed or sitting position in a chair, or slightly elevated right side lying position. For more efficient feeding. 2. Assess tube placement and patency. To ensure that tube is placed in the right place. Auscultate abdomen Aspirate gastric content and check for pH Immerse tip of tube in water X-ray

3. Assess residual feeding contents. To assess absorption of the last feeding. 4. Introduce feeding slowly. To prevent flatulence, crampy pain and or reflex vomiting. 5. Height of feeding should be 12 inches above the tubes point of insertion into the client. This allows slow introduction of feeding. 6. Instill 60 mL of water into the NGT after feeding. To cleanse the lumen of the tube thus, preventing microorganism from thriving. 7. Clamp the NGT before all the water is instilled. To prevent entry of air in the stomach. 8. Instruct client to remain in fowlers position or in slightly elevated right lateral position for at least 30 minutes. To prevent regurgitation of feeding. 9. Document. To prevent repetition of the procedure.