Nursing 105

Essentials of Nursing Study Guide Nasogastric Tube Insertion Example

©2018 Achieve Page 28 of 160 The correct positioning of the tube must be verified at the following times: • Immediately after initial placement • Before each feed • Following vomiting/coughing and after observing decreased oxygen saturation • If the tube is accidentally dislodged or the patient complains of discomfort There are two ways of confirming the tube’s position currently recommended. These are by pH test and X-ray. Other methods can be inaccurate and should not be used. • pH test: The NG tube is aspirated and the contents are checked using pH paper, not litmus paper. • Chest X-ray: When in doubt, it is best practice to use X-ray to check the tube’s location. This involves taking a chest X-ray including the upper half of the abdomen. The tip of the tube is a white radiopaque line and should be below the diaphragm on the left side. Nursing Interventions Prior to Tube Feeding Before a feeding tube is placed, the following are common interventions: • assess for signs of dehydration or malnutrition • check for allergies to any food in the feeding • verify bowel sounds and note any problems with previous feeding • check expiration date on feeds and ensure that the feeding is at room temperature (to prevent abdominal cramping) • verify placement • assess the amount of residual gastric content and measure; if more than 100ml or more than half of the prior feed, hold and notify physician. • check patency of the feeding tube by instilling 50-100ml of water