Question

What is the correct way to measure NGT and how is it inserted into the patient?

In what 3 ways can the TNG (if it is in place) be checked for patent?

What can be a complication for the patient of not placing the tube correctly?

What are the nursing interventions (management) with these patients?

Answer 1

1)What is the correct way to measure NGT and how is it inserted into the patient?

Nasogastric tube is used for feeding, administration of medication and other oral agents.Before an nasogastric tube is inserted, it must be measured from the tip of the patient’s nose, loop around the ear and then down to roughly 1-2 inches below the xiphoid process. The tube is then marked at this level to ensure for the length gone to stomach.

Lubricate the end of the tube and insert into one of the anterior nares of patient. Once it reach oro pharynx, patient might have gag reflex, if they are alert, advise them to swallow, thus the tube will move downwards. Once it reaches esophagus, it is easy to insert to the stomach. The tube must be secured to prevent from moving.

2)In what 3 ways can the TNG be checked for patients?

* Syringe method _where aspirate the stomach contents through the tube.

* Auscultation _Inject some air using syringe via tube, place the stethoscope on stomach to hear the injected air push.

* Bubbling method_Open the tube and place it in the bowl containing water, if babbling present, it shows proper placement of tube.

3)What can be the complications if tube not placed properly?

*Nose bleeds

* Sinusitis

* Sore throat

Sometimes more significant complications occur including erosion of the nose where the tube is anchored, esophageal perforation, damage to a surgical anastomosis, pulmonary aspiration, a collapsed lung, or intracranial placement of the tube.

4)What are the nursing interventions?

* Always check the placement of tube before feeding or placing _to avoid mispassage of contents

* Check for any complications like nose bleeds or pain

* Ensure that tube is secured properly at nasal nares

* Avoid excess air entry through the tube to stomach _brings discomfort and gastric problems.

* Keep the tube clean, rinse the tube after feed with water

* Avoid infection

* Perform hand hygiene before handling with tube