NG Tubes Flashcards
What types of GI intubation can be done?
- Orogastric
- Nasogastric
- Gastrostomy
- Jejunostomy
What is the purpose of nasogasric/enteric tubes?
- Decompression (ex. intestinal blockage)
- Nutrition
- Lavage (washing out of body cavity)
- Diagnostic
What do we need to consider before giving an NG tube?
- Purpose
- Patient (age, dementia, etc.)
- Type of tube required
- Size of the tube
- Policy (UFV & agency)
What are the different types of tubes?
- Levine
- Salem sump
- Feeding tubes
What are the different sizes of NG tubes?
- Related to purpose
- Nutrition: less than 12, small bore or longer
- Decompression: 12 to 16 Fr., large bore and shorter
- Lavage: up to 18 Fr.
According to UFV policy, when do we NOT insert NG tubes?
- Unconscious
- No gag or swallow reflex
- Neck or facial trauma or surgery
- Basal skull fracture
- Esophageal varices or obstruction
- Recent upper GI surgery
- Thermal or chemical injury to upper GI or Respiratory tract
What equipment is required for NG tubing?
- Tube (14 to 16 Fr.)
- Gloves
- Water soluble lubricant
- pH test strips
- Tongue depressors
- Flashlight
- Catheter tipped syringe
- Tape or tube fixator
- Tissue
- Water with straw
- Stethoscope
- Save-a-day tray
- Incontinence pad
What are steps 1-5 of NG tube insertion?
1) Check the physician’s order
2) Assess & prepare patient (ensure privacy)
3) Prepare for procedure (positiion selt, gather equipment, hand hygiene)
4) Examine nose
5) Measure and mark (nose, ear, xiphoid process)
What are steps 6-10 of NG tube insertion?
6) Lubricate the tube
7) Alert the client about the commencement of the procedure
8) Instruct client to extend neck back against pillow
9) Insert the tube slowly through the naris, with curved end pointing downward
10) Once past the nasopharynx, instruct client to flex his head forward and swallow water
What are steps 11-15 of NG tube insertion?
11) Advance 2 to 5 cm with each swallow
12) Continue to advance the tube until desired length has been inserted
13) Secure the tube slightly to nose, while checking for placement; anchor tube when placement is confirmed
14) HOB should remain elevated at 30 degrees
15) Remove gloves and wash hands
How and when do we check for placement of the tube?
- Ask client o talk
- Inspect posterior nares for evidence of coiled tube
- Check aspirate for pH volume (wait one hour post insertion)
- Check for changes in residual volumes
- Check q4h, with documentation, and verify tube length q8h
What do we record and report?
- Time and type of NG tube inserted
- Client’s tolerance of procedure
- Confirmation of placement
- Character of gastric contents and pH value
- Whether tube is clamped or connected to drainage device
- Amount and character of NG drainage every shift
What are the two different types of suction?
- Wall suction (hospital rooms)
- Gomco
How do we establish gastric suctioning?
1) Gather equipment and check (no leaks)
2) Connect to NG tube
3) Turn on suction (as ordered by physician)
4) Observe function
5) Monitor patient: GI system, respiratory system, F & E balance
6) Monitor suction system regularly
7) Check tube placement
8) Avoid reflux through blue pigtail
9) Empty, measure, observe & document
What is the purpose of irrigation of NG tube? (i.e. cleansing with water)
Maintain patency of tube to ensure continued sunctioning
