Chapter 10. Tubes and Attachments Show Using a Nasogastric TubeA nasogastric (NG) tube is a flexible plastic tube inserted through the nostrils, down the nasopharynx, and into the stomach or the upper portion of the small intestine. Placement of NG tubes is always confirmed with an X-ray prior to use (Perry, Potter, & Ostendorf, 2014). NG tubes are used to:
An NG tube used for feeding should be labelled. The tube is used to feed patients who may have swallowing difficulties or require additional nutritional supplements. These tubes are narrower and smaller bored than a Salem sump or Levine tube. An NG tube can also remove gastric content, either draining the stomach by gravity or by being connected to a suction pump. In these situations, the NG tube is used to prevent nausea, vomiting, or gastric distension, or to wash the stomach of toxins. The NG tube is fastened to the patient using a nose clip, and is taped and pinned to the patient’s gown to prevent accidental removal of the tube and to prevent the tube from slipping from the stomach area into the lungs. When working with people who have nasogastric tubes, remember the following care measures:
Checklist 78 outlines the steps for inserting a nasogastric tube. Checklist 78: Inserting a Nasogastric tube
Special considerations with NG tubes:
Video 10.1Removing an NG TubeAn NG tube should be removed if it is no longer required. The process of removal is usually very quick. Prior to removing an NG tube, verify physician orders. If the NG tube was ordered to remove gastric content, the physician’s order may state to “trial” clamping the tube for a number of hours to see if the patient tolerates its removal. During the trial, the patient should not experience any nausea, vomiting, or abdominal distension. To review how to remove an NG tube, refer to Checklist 79. Checklist 79: Removal of an NG Tube
What position is best for tube feeding?Position: Lying prone/supine during feeding increases the risk of aspiration and therefore where clinically possible the child should be placed in an upright position.
Which is the best position to reduce the incidence of aspiration in clients receiving tube feedings?Findings from this study suggest that a combination of a head-of-bed position elevated to at least 30 degrees and use of a small-bowel feeding site can reduce the incidence of aspiration and aspiration-related pneumonia dramatically in critically ill, tube-fed patients.
How do you prevent aspiration in tube feeding?Follow these guidelines to prevent aspiration if you're tube feeding:. Sit up straight when tube feeding, if you can.. If you're getting your tube feeding in bed, use a wedge pillow to lift yourself up. ... . Stay in an upright position (at least 45 degrees) for at least 1 hour after you finish your tube feeding (see Figure 1).. Which patient positions may be used during enteral feeding?Enteral feeding by nasogastric tube can be delivered in the prone position at the same rate as in the supine position.
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