The ability to safely and effectively insert a nasogastric tube

Question 1

patient id checks

Answer 1

1. full name
2. dob
3. ur number

Question 2

identifies indications for procedure

Answer 2

NGT are inserted to:

• decompress the stomach and upper bowel
• empty the stomach of accumulated gas and fluid
• to provide enteral feeding when the patient is unable to take adequate nutrition orally
• it is only for patients who are able to swallow
• can also be used to administer medication
• Patients who are unable to swallow or are unable to meet their nutritional requirements by mouth – dysphagia and malnutrition

Question 3

outlines safety considerations of procedure

Answer 3

• aspiration of fluid into the lungs
• nasopharyngeal trauma and ulceration
• an order is necessary to initiate feeding and is a legal requirement - ensure patient is verified
• check surroundings, emergency bell, suction, oxygen
• gain consent from patient and inform them the procedure may feel uncomfortable and have them notify you when they need to stop and take a break

Question 4

introduces self to patient, gives clear explanation of procedure and gains patient’s consent whilst maintaining patient privacy

Answer 4

hi my name is thi i’m a student nurse and today I will be inserting a nasogastric tube

because you haven’t been eating very well, the doctor said that you need help with your nutrition with a tube that goes through your nose

have you ever had one inserted before?

tell them it’ll be uncomfortable and to say whether they need a break

tilt head back

high fowler’s position

close curtains or door

hand hygiene and gloves

Question 5

gathers appropriate equipment

Answer 5

• nasogastric tube
• gloves
• lubricant
• tongue depressor
• torch
• drainage bag
• large catheter tip syringe
• tape
• bluey
• spigot
• 2 kidney dishes
• urine container
• ph testing strips

Question 6

performs adequate hand hygiene throughout the procedure (5 moments of hand hygiene)

Answer 6

1. before touching the patient
2. before a procedure
3. after a procedure or risk of body fluid
4. after touching the patient
5. after touching the patient’s surroundings

Question 7

assess and selects appropriate nostril and discuss contraindications for site choice

Answer 7

check both nostrils for obstruction

block one nostril and breathe and see which nostril has better airflow

place bluey on patient’s chest

Assess nostrils for obstruction and choose the nostril with better airflow for tube insertion.

e.g., a patient with deviated septum means one of their nostrils have smaller air passage, making it harder for them to breath when NGT is in

Question 8

determines length of NGT to be inserted

Answer 8

Measure the distance from the tip of the nose to the earlobe to 5cm below the xiphoid process.

Mark this length on the tube with a piece of tape.

Question 9

correctly inserts NGT

Answer 9

apply lubricate

tilt head back

when resistance is felt, apply downward pressure

patient will have water and cup to swallow

Question 10

secures tube to nose appropriately

Answer 10

with tape

Question 11

describes method of checking NG placement

Answer 11

to determine the NGT is in the stomach, use 50ml syringe to aspirate some gastric contents

pH of 1-5 ideal

pH test
This method aspires the NG tube and checks the content by using pH paper. If the ph is 5.5 or less, the tube has be properly placed.

Chest X-ray
This method offer one of the best ways to check the placement of the NG tube.

Question 12

accurately performs ph strip check

Answer 12

pH test
This method aspires the NG tube and checks the content by using pH paper. pH of 1-5 ideal

Question 13

connects to drainage bag or clamps off end of tube

Answer 13

spigot

Question 14

cleans, replaces and disposes of equipment appropriately

Question 15

documents relevant information appropriately

Answer 15

document size and type of NGT used, ease of insertion and the placement