Naso-Gastric Tube

By
Dr. Khalil Abdulqawi El-Aajam
PhD. M.Sc. B.Sc.

Dr. Khalil Abdulqawi El-Aajam 1

Introduction
• GI intubation is the insertion of a plastic tube
into the stomach, the duodenum (first section of
the small intestine), or the intestine.
• The tube may be inserted through the mouth,
the nose, or the abdominal wall.
• The tubes can be short, medium, or long,
depending on their intended use.

Dr. Khalil Abdulqawi El-Aajam 2

Types of GI tubes.
• a. Nasogastric (NG).
• Tube passed through a nostril, the nasopharynx, and the esophagus
with the distal end placed in the stomach.
• Uses for:
1. patients who are unable to ingest substances through the mouth
2. an absent gag reflex
3. recent head and neck surgery
4. decompression after abdominal surgery.
5. Gastric lavage

Dr. Khalil Abdulqawi El-Aajam 3

b. Jejunostomy.
• Tube passed through the nose, the esophagus,
and the stomach with the distal end placed in
the jejunum.
• Uses for:
1. patients with impaired gastric functioning so
that formula feedings can directly enter the
small intestine
2. promote intestinal decompression in patients
with a small bowel obstruction.
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Reasons to use GI tubes
1. To decompress the stomach and remove fluid
2. To lavage the stomach
3. To diagnose disorders of GI motility
4. To administer medications and feedings
5. To treat an obstruction
6. To compress a bleeding site
7. To aspirate gastric contents for analysis
Dr. Khalil Abdulqawi El-Aajam 5
Nursing management of patients
undergoing nasogastric intubation
1. Instructing the patient about the purpose of the tube and the
procedure required for inserting and advancing it.
2. Describing the sensations to be expected during tube insertion
3. Confirming the placement of the NG tube
4. Monitoring the patient and maintaining tube function
5. Providing oral and nasal care
6. Monitoring for potential complications
7. Removing the tube

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Intubation equipment
1. Sterile gloves
2. NGT
3. Stethoscope
4. Plaster
5. Gauze or Tissue
6. Water
7. Kidney dish
8. Tray
9. Lubricant gel
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Tube insertion
1. Gather Equipment and measure the tube
2. The patient is placed in Fowler’s position, and the nostrils are
inspected for any obstruction. The more patent nostril is
selected for use. The tip of the patient’s nose is tilted, and the
tube is aligned to enter the nostril.
3. When the tube reaches the nasopharynx, the patient is
instructed to lower the head slightly and to begin to swallow as
the tube is advanced. The patient may also sip water to
facilitate advancement of the tube.
4. The oropharynx is inspected to ensure that the tube has not
coiled in the pharynx or mouth.
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Tube measuring

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Confirming Placement
1. Measurement of tube length
2. Insufflate 20 mL of air through the tube and listen by
stethoscope.
3. Change the patient’s position and attempt to
aspirate.
4. Visual assessment of aspirate
5. pH measurement of aspirate
6. X-ray
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Securing the tube

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NGT feeding
Nursing care during feeding
1. give an appropriate feeding formula
2. Elevate the patient’s head to 45 degree
3. Give the formula slowly and ensure it is in room
temperature
4. Check the amount and fullness
5. Check for signs of dehydration or edema
6. Monitor I&O
7. Wight the patient daily
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Removing the Tube
• Flush it with 10 mL of normal saline to ensure that it is
free of debris and away from the gastric lining.
• Gloves are worn to remove the tube.
• The tube is withdrawn slowly for 15 to 20 cm until the
tip reaches the esophagus; the remainder is
withdrawn rapidly from the nostril.
• If the tube does not come out easily, force should not
be used, and report the problem to the physician.
• After the tube is removed, the nurse provides oral
hygiene Dr. Khalil Abdulqawi El-Aajam 15
Complications

1. Fluid volume deficit

2. Pulmonary complications
3. Tube-related irritations
4. Aspiration

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