NG, OG, tube insertion/removal- Lab

Question 1

Review the child’s history for

Answer 1

trauma, nasal or palate deformity, epistaxis, gastric fundoplication, gastric or
esophageal surgery, esophageal malformations or injuries, and pyloric malformations.

Question 2

measuring

Answer 2

from the tip of the nose to the earlobe, then from

the earlobe to the midpoint between the xiphoid and the umbilicus.

Question 3

placement

Answer 3

Gently but steadily thread the tube through either the mouth or one of the nares to the previously identified
mark. Avoid extending the head backward. If a cervical spine injury is present, do not flex the child’s head. If
passage is difficult or if choking, coughing, cyanosis, or decreased oxygen saturation occur, STOP, remove
the tube and reattempt placement at a different angle.

Question 4

nasal placement

Answer 4

placement: Insert the tube into a patent nostril, aiming posterior and parallel to the nasal septum.
When the tube touches the pharynx, flex the child’s head forward and, if the child is cooperative, ask the
child to swallow. Advance the tube as the child swallows. Infants may be offered a pacifier.

Question 5

PO Placement

Answer 5

Position the end of the tube downward and insert the tube into the oral cavity over the
tongue. Aim the tube back and down toward the pharynx. When the tube touches the pharynx, flex the head
forward. If the child is cooperative, ask the child to take sips of water through a straw while the tube is
advanced.

Question 6

confirmation correct placement

Answer 6

abdominal radiograph. Do not rely on the auscultation

method to confirm tube placement.

Question 7

Removal

Answer 7

1. Position the child in the supine position. Elevate the head of the bed as tolerated by the child. If indicated,
   enlist a second person to help keep the child immobile during the procedure and/or encourage parental
   presence for support.
2. Gently remove tape from under the lip or cheek. Consider the use of skin adhesive remover to assist in the
   removal of tape.
3. Occlude the tube by pinching it closed, bending it, and holding it with the thumb and index finger. Pull the tube
   out of the mouth or nose using a swift, consistent motion.

Question 8

Completing the Procedure

Answer 8

1. Monitor the child’s tolerance of NG or OG tube placement.
2. Monitor proper tube placement.
3. Monitor the insertion site of the tube.
4. Assess, treat, and reassess pain according to institution standard.
5. Discard supplies, remove gloves, and perform hand hygiene.
6. Document the procedure in the child’s record.