Barbon, Donna D.

BSN3-D

LEARNING ACTIVITIES

 Angela is working as a nurse and is preparing to insert an NGT to a patient in vehicular accident. Please enumerate all the materials needed by
Angela.
Materials:
1. Gloves
2. Nasogastric tube
3. Water-soluble substance (K-Y jelly)
4. Protective towel covering for client
5. Emesis basin
6. Tape for marking placement and securing tube
7. Glass of water (if allowed)
8. Straw for glass of water
9. Stethoscope
10. 60-mL catheter tip syringe
11. Rubber band and safety pin
12. Suction equipment or tube feeding equipment

 Enumerate the steps that she needs to perform prior to insertion

Steps in NGT insertion:

1. Review the physician’s order and know the type, size, and purpose of the NG tube.
2.  Check the client’s identification band. 
3. Gather equipment, set up tube-feeding equipment or suction equipment mentioned above. 
4. Briefly explain the procedure to the client and assess his capability to participate
5. Observe proper hand washing and don non-sterile gloves. 
6. Position client upright or in full Fowler’s position if possible. 
7. Measure tubing from bridge of nose to earlobe, then to the point halfway between the end of the sternum and the navel
8. Wipe the client’s face and nose with a wet towel. 
9. Cover the client’s eyes with a cloth. 
10. Examine nostrils for deformity or obstruction by closing one nostril and then the other and asking the client to breathe through the nose for each
attempt. 
11. Lubricate 4 to 8 inches of the tub with a water-soluble lubricant
12. Flex the client’s head forward, tilt the tip of the nose upward and pass the tube gently into the nose to as far as the back of the throat. Guide the
tube straight back.
13. Once the tube reaches the nasopharynx, allow the client lower his head slightly. 
14. Instruct the client to swallow as the tube advances. 
15. If changes occur in patient’s respiratory status, if tube coils in mouth, if the patient begins to cough or turns cyanotic, withdraw the tube
immediately
16.  If obstruction is felt, pull out the tube and try the other nostril
17. Advance the tube as far as the marked insertion point. 
18. Check the back of the client’s throat to make sure that the tube is not curled in the back of the throat
19. Secure the tube with tape or commercially prepared tube holder once stomach placement has been confirmed.