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PURPOSE
A nasogastric tube may be used to decompress the stomach,instill medications or feedings, or to assess gastrointestinalfunction.
EQUIPMENT
Appropriate size nasogastric tube Water-soluble lubricant
1
 / 
2
-inch tape1 Transparent dressingSyringe1 Hypoactive dressingBlanket for restraint, if appropriateGloves, nonsterile (exam)Pacifier, if appropriateEmesis basisPin and rubber bandTowelStethoscope
NASOGASTRIC TUBE SELECTION
GUIDELINES
Type of tubeFor gavage or lavage use a single lumentube.For intermittent gastric decompression usea double lumen tube.For continuous long-term feeding use a sil-icone tube.Tube size2 Kg5 French3–9 Kg8 French10–20 Kg10 French20–30 Kg12 French30–50 Kg14 French> 50 Kg16 French
PROCEDURE
1.Gather equipment. Select appropriate size and type of nasogastric tube. Some guidelines are presented above;however, the nurse must use his or her judgment or fol-low agency policies.
Promotes organization and effi-ciency.
2.Wash hands. Put on nonsterile gloves.
Reduces transmis- sion of microorganisms and protects from contact with body fluids.
3.Prepare child and family.
Enhances cooperation and participation and reduces anxiety and fear.
4.Position child supine at a 30°–45°angle if possible.5.Assess patency of nares.6.Measure length of tube to be inserted and mark tube with a piece of tape. Several methods of measuringlength of nasogastric tube to be inserted have beenidentified.a.Measure from the tip of the nose to the earlobe andfrom the earlobe to the lower end of the xyphoidprocess. This is a commonly used method.b.Measure from the nose to the earlobe and from theearlobe to a point halfway between the xyphoid andthe umbilicus. (Figure21A)c.Formulas based on height.7.Place a towel over the child’s chest to protect clothing.8.Lubricate 1 to 3 inches of the tube with water or a water-soluble gel.9.Insert tube back and up into nostril; advance using gen-tle pressure. If resistance is met, withdraw the tube,relubricate and try the other nostril. (Figure21B)10.If the child is able, ask child to swallow as the tube isadvanced. A pacifier may be used for an infant over 3months of age who does not need to mouth breathe.Continue to advance the tube until the tape mark is atthe nostril.
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Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.
SKILL 20SKILL 20
Insertion ofa Nasogastric Tube
FIGURE 21A 
Measuring NG tube distance.
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