DISTURBANCE IN

METABOLISM

GASTRIC INTUBATION
Insertion of a rubber
or plastic tubing
through the nose or
mouth into the
stomach

PURPOSES
To remove gastric contents for the
following reasons:
To obtain specimen for laboratory exams
To decompress stomach of fluids or gas
(paralytic ileus, abdominal surgeries)
To cleanse stomach

PURPOSES
To introduce nourishment or medication to
a patient who is
Semiconscious or unconscious
Very weak
Operated on the mouth, tongue or jaw
Severely anorexic

EQUIPMENT TO BE USED

NGT fr 12-18
Water soluble lubricant
Asepto-syringe
Flashlight
Tongue depressor
Disposable gloves
Adhesive tape- leukoplast
stethoscope

IMPLEMENTATION
Assist the client to a high fowlers position
Explain to the client what you are going to
do
Wash hands
Provide client privacy
Assess the clients nares
Hyperextend the head,use a flashlight to
check for the intactness of the nares

Prepare the tube

 Determine how far to

insert the tube
Use the tube to mark
off the distance from
the tip of the clients
nosetip of the
earlobetip of the
xiphoid (NEX
method)

 Insert the tube

Put on gloves
Lubricate the tip of the tube using water
lubricant gel
Insert the tube with its natural curve toward
the client into the selected nostril.
Hyperextend the neck and gently advance the
tube toward the nasopharynx
Once in the oropharynx, ask the patient to
swallow

 Ascertain correct placement of the tube

Visualizing the tube inside the mouth
Aspirate gastric contents
Auscultating air insufflation by placing a
stethoscope over the clients epigastrium and
injecting air into the tube while listening for a
gurgling or whooshing sound
Best way: x-ray

 Secure the tube by placing a tape to the

bridge of the clients nose
Attach the tube to a suction source or
feeding apparatus or clamp the end of the
tubing
Secure the tube to the clients gown

 Keep patient in a
comfortable position

 Documentation
Date & Time of procedure done
What size of NGT was used
Character and amount of gastric aspirate
Specimen obtained, examination desired and
send to laboratory
Any untoward reactions during the procedure
If the tube is clamped, draining independently
or connected to a suction apparatus

GASTRIC LAVAGE
Definition
Method of washing out the stomach contents
by first introducing then withdrawing
prescribed solution through an NGT passed
into the stomach

GASTRIC LAVAGE
Purpose
For diagnosis
For therapeutic use such as
To cleanse the stomach preoperatively and
post-operatively

GASTRIC LAVAGE
General considerations
Remove dentures before insertion of tube
Be certain that the tube is in the stomach and
not in the trachea before administering any
solution
Clamping off the tube is extremely important
when withdrawing the tube to prevent
aspiration of liquid from the end of the tube
Observe for sudden pain or weakness
following insertion as this may indicate
perforation of pre-existing lesion

GASTRIC LAVAGE
Contraindications
Ulceration with hemorrhage d/t ulcer or CA
Uncompensated cardiac disease
Advanced TB

IMPLEMENTATION
Check if the tube is in place by listening
with stethoscope over the stomach
Pour the solution into syringe holding it
about 12 inches above the patients
head.Then lower the tube into the kidney
basin before the solution has entered the
stomach and siphon

 Repeat the irrigation until flow from the

stomach is clear or the ordered amount of
solution has been used
Observe the patient closely
Document
Time
Nature,amount and strenght of solution used
Character of return flow
Specimen saved

BOLUS TUBE FEEDING

GASTRIC GAVAGE
Purpose
Provide nutrition supplementation to patients
who cannot ingest adequate amounts of
nutrients orally

GASTRIC GAVAGE
Equipment
Aseto-syringe
Stethoscope
Tongue depressor
Calibrated glass/cup
Distilled water
Osteorized feeding

IMPLEMENTATION

Wash hands
Organize equipment and prepare formula
Explain the procedure
Place px in semi-high fowlers position
Verify tube placement
Check for residual

IMPLEMENTATION
Fill the syringe with formula and allow to
flow slowly into the NGT, holding the
aseptosyringe 6 inches above tube
insertion site
Do not allow syringe to empty until formula
and water have completely infused
Prevents air from entering the stomach

IMPLEMENTATION
Clamp the tube
Let the px stay in semi-fowlers position for
at least 30 minutes after feeding
Decrease reflux of feeding and possible
aspiration

Wash hands and properly store equipment

DOCUMENTATION
Assessment of tube placement
Assessment of site of tube entry
Amount of residual feeding
Amount and type of product given
Amount of water given in between
feedings
Client position before and after feeding
Client tolerance of procedure
Health teachings