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Insertion
Nursing Guidelines and considerations
Purposes
Treatment for mechanical obstruction
Administering meds and food (gavage)
Specimen procurement of gastric contents
for Lab studies when pyloric or intestinal
obstruction is suspected.
Unconscious pt’s- advance tube between
respiration
1
Consider this!
Nasal obstructions- pass tube to the
mouth instead.
a. Remove dentures, slide distal end over
the tongue then proceed just like usual
way of NGT insertion
b. Coil end of the tube, directing it
downward the pharynx
Pain or vomiting- indicates obstruction or
wrong placement
If NGT is not draining, reposition the tube
(per physician’s order)
Assess the color, consistency, odor of
gastric contents and report any
unusualities2
Auscultate! Auscultate! Auscultate!
Irrigate before and after giving
medications
Know the complications if tube stays for
prolonged periods:
nasal erosion and sinusitis
Esophagitis and esophagotracheal fistula
gastric ulceration, and pulmonary and oral
infections
Let’s Begin
Nasogastric (NG) tube- usually single-
lumen Levin
H20-soluble lubricant
Clamp for tubing
Towel, tissues, emesis basin
Glass of H2o and straw
Tape (preferably hypoallergenic)
Equipments (basic)
Asepto syringe 3
Stet
Penlight
Disposable gloves
Normal saline
1. Ask the patient if he has ever had nasal
surgery, trauma, a deviated septum, or
bleeding disorder .
4
Procedure: Preparation
4. Determine with the patient what sign he
might use, such as raising the index
finger, to indicate “wait a few moments”
because of gagging or discomfort .
7
Performance
4. When tube reaches the pharynx, the
patient may gag; allow patient to rest for
a few moments .18
Follow up phase
4. Apply petroleum jelly to nostrils as
needed, and assess for skin irritation or
breakdown . 36
Equipments
1. Make sure that gastric or small bowel
drainage is not excessive in volume.
2. Make sure, by auscultation, that audible
peristalsis is present.
3. Determine whether the patient is
passing flatus; this indicates peristalsis .
39
Procedure: Preparation
4. Verify the health care provider's order
for removal.
1. Place a towel across the patient's chest,
and inform him that the tube is to be
withdrawn .
40
Performance phase
5. Slowly, but evenly, withdraw tubing and
cover it with a towel as it emerges . (As
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