Question

What are the medical indications (purpose, what does the MD seek or what does he want to achieve) when inserting a nasogastric tube?

What aseptic measures are necessary when placing a NGT?

What security measures should you implement when inserting a NGT?

What anatomical position should the patient be in when placing a NGT?

How should we calculate the length to insert NGT?

What type of moisturizer should be applied to the NGT before inserting into the nostril?

The patient should be told what I brought to minimize nausea caused by the insertion of NGT (true or false).

What steps should we take to verify that the NGT is correctly positioned?

If the tube is placed to administer medications, should it remain (open in free fall or occluded)?

At the end of the procedure, the nursing staff must ensure that the patient is comfortable, has the intercom close by, the rails raised, and must document the procedure in the clinical record (true or false).

Answer 1

INDICATIONS

1Gastric decompression, including maintence of a decompressed state after endotracheal intubation,often via oropharynx

2 Relief of symptoms and bowel rest in the setting of small bowel obstruction

3 Aspiration of gastic content from recent ingestion of toxic material

4 administration of medication

5 Feeding

6 Bowel irrigation

7 Obtain specimen of the gastric contents

8 Asseement of GI bleeding

ASEPTIC TECNIQUE

1 NG insertion is a clean procedure.The potential for contact with a patienta's blood or body fluids while inserting NG tube.

2 Clean gloves must be worn while inserting

3 If there is a risk for vomiting face shield, eye protector or apron might be used.

4 Keep a rubber sheet under the patient's head to prevent the contamination of patient bedsheet with the secretion or vomitus and a towl over the chest to prevent soiling of patients gown

SECURITY MEASURES

1 Explain the procedure to patient for cooperation during the procedure

2 Side rails of the opposite side should be kept raised

3 Patient should be connected to the cardiac minitor during insertion. Check saturation and respiratory rate while inserting the tube to dectect any respiratory distress

4 Oxygen supply should be kept ready if the patient shows any respiratory distress

5 Select appropriate sized tube to prevent injury while inserting

ANATOMICAL POSITION

High fowlers or sit up positionwith pillows behind the head and shoulders which promotes clients ability to swallow.

LENGTH OF NGT

Measure distance from tip of nose to earlobe to xiphoid process (approximate measure from naris to stomach)

MOISTURIZER

Water soluble lubricating gelly / 2% xylocaine jelly

FALSE. NGT insertion is a uncomfortable procedure may obiviously cause nausea feeling as the nurse touching the roof of mouth with tube which cannot be avoided

POSITION

1 Ask the client to talk. Inability to talk means tube passes trough the vocal cords into the lungs.

2 inspecthe the posterior pharynx for coiled tube.

3 aspirate the gastric ontentsand observe the color.Gastric content are usually cloudy and greenbut may be off white, tan or brown. aspiration of contents provides means to measure flud PH ( should be below 6) and thus determine the tube placement in GIT. Duodenal placement shows bile color and esophageal shows may or may not with saliva

4 Xray examination

Tube must be occluded after administring medication for better absorption

TRUE