INSERTION OF A NASOGASTRIC TUBE Flashcards
What are the primary indications for NG tube insertion?
Feeding, medication delivery, removal of gastric contents, diagnostic, and therapeutic purposes.
When is an NG tube indicated for feeding?
When a person is malnourished or at risk of malnutrition with inadequate or unsafe oral intake and a functional GI tract.
Give examples of conditions where NG tube feeding may be necessary.
Neurological conditions causing dysphagia, lowered consciousness, or post-operative GI surgery.
How is an NG tube used for medication delivery?
Certain medications are delivered directly into the stomach if oral intake is inadequate or unsafe.
What are some indications for using an NG tube to remove gastric contents?
Gastric decompression in intubated patients, symptom relief in bowel obstruction, and aspiration of ingested toxins.
List diagnostic uses for an NG tube.
Investigating suspected upper GI bleed, aspirating gastric fluid, and administering radiographic contrast.
What are therapeutic uses for an NG tube?
Decompressing a distended stomach, preventing aspiration during surgery, nutritional support, GI lavage, and administering medications.
What are contraindications for NG tube insertion?
Patient refusal, severe facial trauma, recent nasal or sinus surgery, esophageal or nasal obstructions, bleeding tendencies, and esophageal varices.
Why is patient preparation important for NG tube insertion?
To ensure patient safety, comfort, and the effectiveness of the procedure.
List the documentation required for NG tube insertion.
Patient notes should include tube size, insertion depth, complications, and placement confirmation method.
What equipment is necessary for NG tube insertion?
Non-sterile gloves, linen saver, NG drainage bag, tube, lubricant, syringe, stethoscope, pH litmus paper, tape, emesis basin, water, straw, and suction equipment.
How should the patient be positioned for NG tube insertion?
Sit the patient up at a 45° angle with neck flexed forward.
How is the NG tube insertion depth determined?
Measure from the nose tip to the earlobe and down to the xiphoid process.
What is the first procedural step in NG tube insertion?
Perform hand hygiene and put on non-sterile gloves.
What should be placed on the patient before inserting the NG tube?
A linen saver on the chest and an emesis basin for any potential vomit.
How should the NG tube be prepared before insertion?
Lubricate the tip with a water-based lubricant like KY jelly
Why is it important to inspect the patient’s nostrils?
To ensure there are no obstructions that could hinder tube insertion.
What direction should the NG tube be aimed during insertion?
Aim downward and backward toward the opposite ear.
Through which nostril should the NG tube be inserted?
Use the most open nostril and insert horizontally.
What should the patient do when the NG tube reaches the pharynx?
Flex their head forward and swallow or sip water if allowed.
When should you stop advancing the NG tube?
When the tube reaches the pre-measured insertion depth mark.
How can you confirm the correct placement of the NG tube?
By chest X-ray, aspirating gastric content for pH, or auscultating the epigastrium with injected air.
How should the NG tube be secured?
Secure with tape at the nostril and cheek, ensuring no pressure on the nostril.
What are some risks associated with NG tube insertion?
Bodily fluid exposure, trauma, tracheal intubation, nosebleeds, esophageal perforation, and aspiration.
What post-procedural considerations should be documented?
Document tube size, insertion depth, complications, and placement confirmation method.
What are potential gastrointestinal complications of NG tube insertion?
Mispositioning, coiling or knotting of the tube, reflux leading to esophagitis, strictures, bleeding, or pulmonary aspiration.
How can an NG tube cause gastritis or gastric bleeding?
Through chronic irritation or pressure necrosis from the tube against gastric tissues.
What pulmonary complications can arise from NG tube insertion?
Aspiration pneumonia, lung abscess, tracheal perforation, or pneumothorax.
What intracranial complications can result from NG tube insertion?
Intracranial intubation in cases of maxillofacial trauma or cribiform plate perforation.
What nasal complications may occur due to NG tube insertion?
Alar ulcer, necrosis, epistaxis, and discomfort, especially if there is trauma to the nasopharynx.
Why might a patient with esophageal varices be at risk during NG tube insertion?
Due to the risk of bleeding, as the varices can be traumatized by the tube.
For which condition is an NG tube indicated to provide symptom relief through “drip and suck” management?
Bowel obstruction, to relieve symptoms and allow bowel rest.
In what cases might an NG tube be indicated for diagnostic purposes?
Suspected upper GI bleed, obstruction, or aspiration of gastric fluid for testing.
Name two neuromuscular conditions where NG feeding may be required.
Stroke (CVA) and multiple sclerosis, both of which may impair safe swallowing.
Why is NG feeding sometimes necessary in cancer or sepsis patients?
These conditions can cause physiological anorexia, leading to insufficient oral intake.
What GI dysfunctions may indicate the need for NG feeding?
Dysmotility, inflammatory bowel disease, or reduced bowel length, which impact nutrient absorption.
Why might a patient with burns have increased nutritional requirements necessitating NG feeding?
Burns increase the body’s caloric needs for healing, which may be unmet through oral intake alone.
How can an NG tube prevent aspiration during surgery?
By decompressing the stomach and removing contents that might otherwise be aspirated.
What specific psychological condition might require NG feeding?
Anorexia nervosa, where severe dietary restrictions could lead to malnutrition.
What complication might occur if the NG tube impairs the lower esophageal sphincter?
Reflux, which could lead to esophagitis, strictures, upper GI bleeding, or pulmonary aspiration.
