PREPARED BY:P2LT JOYCE ANGELINE D VALENCIA NC

After 30 minutes of lecture discussion, the Audience/Participants will be able to◦ Understand the definition of Nasogastric tube ◦ Know the Importance of feeding and insertion, its

indication, purpose, precautions◦ Know the Sizes of the Nasogastric tube for adults and

pediatric patients◦ And the Nursing care of the Patients with a nasogastric

tube

Fundamentals of Nursing fifth Edition by Kozier, Erb, Blais, Wilkinson; Copyright 1998; pages 1044-1046

Fundamentals of Nursing Checklist Seventh Edition by Kozier, Erb, Berman, Snyder; Copyright 2004; pages page 60

Textbook of Medical-Surgical Nursing Eleveth Edition by Brunner and Suddarth; Copyright 2001; pages 1182-1183

Nasogastric Tube◦ Definition

Nasogastric Feeding/Insertion◦ Indications◦ Standard Solutions◦ Purpose◦ Precaution

Sizes of the Nasogastric tube Nursing Care of the Patient

• A tube that is made of plastic or silicon and is inserted through the nose(naso) to the stomach(gastric) area

Tubefeeding is a type of enteral nutrition (nutrition in the form of an enteral formula, which is delivered into the digestive system in a liquid form).

Perioperative Lavage Aspiration Nutrition Swallowing problems

1 Kcal/ml of solution with protein, fat, carbohydrates (CHO), minerals and vitamins.

Common food: milk, sugar, H2O, eggs, vegetable oil.

Adult: 300-500 ml of mixture/feeding.

to deliver substances directly into the stomach to remove substances from the stomach as a means of testing stomach function or

contents.

Do not use force when inserting a Nasogastric tube

Always check the tube positioning before giving feedings

Keep the patient in an upright or semi-upright sitting position when delivering a tube feeding

Cap or clamp off the Nasogastric tube when not in use to prevent backflow of stomach contents or accumulation of air in the stomach

If patient has severe sinus conditions, nasal obstruction or has had facial surgery, it may be necessary to place a oral-gastric tube

If the amount of gastric aspirate is large prior to a bolus or intermittent feeding, notify the physician

Nasogastric tube placement is meant to be a short-term solution for feeding problems

Keep the patient in an upright or semi upright position after the feeding

What are the Indications of Nasogastric tube insertion and feeding?

Perioperative Lavage Aspiration Nutrition Swallowing problems

Adult - 16-18F

In pediatric patients, the correct tube size varies with the patient’s age.

TO FIND THE CORRECT SIZE, ADD 16 TO THE PATIENT’S AGE IN YEARS AND THEN DIVIDE BY 2 (EG, [8 Y + 16]/2 = 12F)

SizeFG-8

FG-10

FG-12

FG-14FG-16FG-

18FG-20

Colour Code

Blue

Black

White

Green

OrangeRedYello

w

Provide good oral hygiene at regular and frequent intervals

Keep the nostrils free of accumulations of dried secretions.

If permissible, apply lubricant such as Vaseline to the lips and nostrils for the patient's comfort

Encourage the patient to swallow saliva naturally

Report complaints and signs of nose or throat irritation

Encourage the patient to change position as necessary

Follow diet orders exactly. If water or clear fluids are allowed by mouth, be sure to check on amount to be given at one time

Keep accurate intake and output records

Secured the tube Meeting patient comfort needs Monitoring patient responses

Nurse’s actionIf tube is in stomach

If tube is in lungs

1 .Attach distal end of the tube to syringe and withdraw plunger

Some gastric contents will fill tube

No fluid will be in tube

2 .Using a stethoscope, listen over the epigastric area of the abdomen while injecting 10ml of air into tube.

Air will make a rushing sound

There will be no sound

3 .Listen to distal end of tube.

There will be no sound.

There will be a crackling sound.

Nurse’s actionIf tube is in stomach

If tube is in lungs

4 .Ask conscious client to talk and hum

Client will be able to talk and hum.

Client will be unable to talk or hum and will cough and/or choke

5 .Note unconscious client’s color.

Color will be normal.

Client will be cyanotic.

6 .Place end of tube in a glass of water while client exhales

Few, if any, bubbles will appear in water.

Steady steam of bubbles will appear.

7 .Checked through x-ray

No tube will appear

It will appear on the xray

• Used for feeding and administering drugs and other oral agents such as activated charcoal, aspiration (suction) which is the process of draining the stomach's contents via the tube and for Nasogastric Lavage

• Tubefeeding is a type of enteral nutrition (enteral formula is delivered into the digestive system in a liquid form).

• Indications of NGT Feeding: PLANS

• There are certain precautions when giving a Nasogastric feeding

• There are certain sizes and colors of NGT that is varies according to patient’s age and sizes

• There are different methods on checking the patency of the Nasogastric Tube

“Meeting the patient’s needs in times of sickness is a good presentation that you are in the right track of making him feel better”

You have learned that ◦ Nasogastric Tubefeeding is a very important alternative

tool to provide feeding, irrigating stomach, for decompression, for administering medications and administering supplemental fluids