The nurse is providing care to a client who is receiving enteral feedings via a nasogastric tube
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.
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
When caring for a client who is receiving enteral feeding the nurse would take which measure to prevent aspiration?If unable to sit up for a bolus feed or if receiving continuous feeding, the head of the bed should be elevated 30-45 degrees during feeding and for at least 30 minutes after the feed to reduce the risk of aspiration.
What are nursing considerations when administering an enteral feeding?When beginning enteral feedings, monitor the patient for feeding tolerance. Assess the abdomen by auscultating for bowel sounds and palpating for rigidity, distention, and tenderness. Know that patients who complain of fullness or nausea after a feeding starts may have higher a GRV.
What safety measures have to be maintained while the patient is receiving an enteral tube feeding?Wear gloves when handling feeding tubes and avoid touching can tops, container openings, spikes and spike ports. Label equipment: Labels should include the patient's name and room number, the formula type and rate, the date and time of administration and the nurse's initials.
What are the nursing responsibilities related to NG tube feedings?The following are the nursing considerations you should watch out for: Provide oral and skin care. Give mouth rinses and apply lubricant to the patient's lips and nostril. Using a water-soluble lubricant, lubricate the catheter until where it touches the nostrils because the client's nose may become irritated and dry.
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