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 10441046 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 shortterm 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
Size FG-8 FG-10 FG-12 FG-14 FG-16 FG-18 FG-20

Colour Code

Blue

Black

White

Green

Orange

Red

Yellow

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

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

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

Nurses action

If tube is in stomach

If tube is in lungs No fluid will be in tube There will be no sound

Attach distal end of. 1 Some gastric the tube to syringe and contents will fill withdraw plunger tube Using a stethoscope,. 2 Air will make a listen over the epigastric rushing sound area of the abdomen while injecting 10ml of .air into tube Listen to distal end of. 3 There will be no .tube .sound

There will be a .crackling sound

Nurses action

If tube is in stomach

If tube is in lungs

Ask conscious. 4 client to talk and hum

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

Note unconscious. 5 Color will be .clients color .normal Place end of tube. 6 in a glass of water while client exhales Checked through. 7 x-ray

Few, if any, Steady steam of bubbles will .bubbles will appear .appear in water 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 patients age and sizes There are different methods on checking the patency of the Nasogastric Tube

Meeting the patients 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