NG Tube Objectives

Question 1

Identify conditions in which NG tubes may be required.

Answer 1

Decompress stomach to remove gas and fluid; diagnose GI disorders; administer tube feedings, fluids, and medications; lavage the stomach to remove ingested toxins; intestinal obstruction; when esophagus and stomach need to be bypassed; at risk for aspiration due to gastric reflux

Question 2

Describe the different types of enteral tubes & the purpose for which they are required.

Answer 2

Levin Tube: used to administer feedings and medications
Dobhoff: used to administer feedings and medications
Salem-sump Tubes: useful for irrigating the stomach and drawing out fluid/gas from stomach

Question 3

Demonstrate the proper way to insert an NG tube, determine proper placement, secure, connect to suction & remove an NG tube.

Answer 3

Measure: measure from tip of nose, to the tip of the ear, down to the xiphoid process
Insert: instruct to flex head back toward pillow when first inserted, when pharynx is met then touch chin to chest and sip water to advance the tube down and back as they swallow; stop when breathing; patient may gag and cough but if persists then stop and check placement
Proper placement: attach syringe to end of tub and aspirate gastric contents to place on pH paper; obtain abdominal x-ray (KUB)
Secure: apply skin barrier, use 4in piece of tape with 2in split to nose, then across cheek; secure to gown using tape and safety pin
Suction: hook up to suction using a Christmas tree
Remove: turn off suction, flush with 10mL water or 30-50mL air, clamp tube and remove while they hold their breath

Question 4

Discuss how to safely administer feedings & medications through an enteral tube.

Answer 4

Elevate head of bed, check residual q 4 hours, flush with water before and after, note abdomen with distention or firmness, stop feeding if nauseated or vomits, finger sticks q 6 hours

Question 5

Discuss how to safely administer a large-volume cleansing enema.

Answer 5

Flush tube, gravity works best, use liquid meds, crush tablets, record flush and meds as intake

Question 6

Discuss how to accurately measure intake of tube feedings and medications.

Answer 6

Measure so patient doesn’t become dehydrated or fluid-overloaded, measure in milliliters (mL)