NG Tube Insertion and Tube Feeding Flashcards
How to measure NG tube to determine proper length for insertion
put tube at tip of nose
back to earlobe
down to xiphoid process
mark that with a piece of tape
How to position the pt’s head during NG tube insertion
the neck should be hyperextended when you first start to insert the tube
once you feel resistance or the pt begins to gag, you’ve hit the pharynx
pt can bring head forward and take sips of water if able (because swallow motion will help push tube down farther)
List supplies needed to insert an NG tube (10)
NG tube
Lopez valve
water-soluble lubricant
gloves
tape
commercial securement device (if available)
safety pin
60 mL slip tip syringe
pH strips to test pH of gastric contents
glass of water
What is the best practice for confirming NG tube placement?
checking gastric pH (1-5)
How is NG tube placement confirmed at Blessing?
injecting air (30 mL) and listening for bubbling sound over stomach
air bolus
Two ways to secure NG tube
secured to nose with tape
secured to gown with flag of tape and safety pin
When removing NG tube, why is air inserted into the tube prior to removal?
to clear the tube of any secretions, tube feeding, or anything else that may be in the tube
you use air so that the tube will be dry at the end
What should the pt do while the NG tube is being removed?
take a deep breath and hold it to protect the airway and prevent aspiration
Three reasons a pt may need a NG tube
client is unable to ingest foods
upper GI tract is impaired but remainder of intestinal tract is functional
unconscious
What position must a patient be in prior to tube feeding?
Fowlers because it enhances gravitational flow of the solution and prevents aspiration of fluid into the lungs
After doing your AIDET, verifying your patients identity, performing hand hygiene, and properly positioning your patient, what are the next 2 steps that are performed PRIOR to administering a tube feeding?
check the pt’s residual and tube placement confirmation (air bolus)
What type of tubing is used for bottle of tube feeding?
spike set tubing
What type of tubing is used for a can of tube feeding?
top fill tubing
If you are using the top-fill tubing, how many hours’ worth of tube feeding can be added to the bag at one time?
8 hours
How long can the tubing be used before it must be changed?
24 hours
When setting the feeding pump for a continuous tube feeding, what is the flush set at in mL per hour? (Blessing Hospital policy)
25 mL per hour
At Blessing Hospital, how often are residuals checked for patients receiving continuous tube feeding?
Every 4 hours for the first 48 hours until goal rate is achieved, then check every 6 hours
At Blessing Hospital, how often are residuals checked for patients receiving bolus tube feeding?
before each feeding
Describe the rationale for checking the residual on a patient with a continuous tube feeding.
This determines adequate absorption and verifies correct placement of the tube.
A patient at Blessing Hospital has a continuous tube feeding. The residual amount is 550 mL Describe the actions the nurse must take at this time.
Stop the feeding and call the physician.
How much flush is given prior to and after administering a bolus tube feeding? Describe the rationale for flushing the tubing before and after feedings.
The amount of flush given is 30-60 mL because water flushes the lumen of the tube, preventing future blockage by sticky formula.
Since a pump is not used with a bolus tube feeding, how is the feeding administered?
Take the plunger off of a syringe and pour the feeding in the tube of the syringe. (uses gravity)
