Insertion of a Nasogastric Tube (NGT)

Insertion of a Nasogastric Tube (NGT) I. Theoretical Concepts Inserting a tube from the nasal cavity to the stomach II. Objective 1. Introducing liquid food or thawed liquid or solid medicines 2. Removes gastric contents/fluids and gas in the stomach 3. Irrigation due to bleeding/poisoning in the stomach 4. Prevent or reduce nausea and vomiting after surgery or trauma 5. Take specimens from the stomach for laboratory studies III. Indication 1. The patient is unconscious 2. Patients with upper digestive tract problems: esophageal stenosis, mouth/pharyngeal/esophagus tumors, etc. 3. Patients who are unable to swallow 4. Patients after surgery on the mouth/pharynx/esophagus IV. Procedure 1. Tool Preparation: a. NGT number 14 or 16 (for smaller children) b. Jelly c. Tongue spatula d. A pair of gloves e. Flashlight f. Syringe size 50-100 cc g. Plaster h. Stethoscope i. Towel j. Tissue k. Bent 2. Implementation procedures a. Move the tool closer to the client's side b. Explain the action to be taken and its purpose c. Washing hands d. Help position the patient in positionhigh fowler Increases the client's ability to swallow e. Place a towel on the client's chest, place facial tissue within the client's reach f. Wear gloves g. To determine NGT insertion, ask the client to relax and breathe normally by closing one nose then repeat by closing the other nose h. Measure the length of the tube to be inserted using: 1) Traditional method Measure the length from the top of the nostril to the lower earlobe and to the xiphoid process on the sternum 2) Hanson Method First mark 50 cm on the Tube, then take measurements using the traditional method i. Mark the length of the hose that has been measured using tape j. Give jelly to the NGT 10-20 cm long k. Remind the client that the tube will be inserted immediately and instruct the client to position the extension head, insert the tube through the designated nostrill. Makes it easier to insert the tube through the nose and keeps the airway open l. Continue inserting the tube along the nasal cavity. If you feel a bit stuck, twist the tube and don't force it to insert itMinimizes the discomfort of installing an NGT, inserting it by twisting and pulling slightly, helping the tube to enter the end of the pharynx m. Continue installing the tube until it passes the nasopharynx, after passing the nasopharynx (3-4 cm) encourage the client to bend the neck and swallow n. Encourage the client to swallow by giving a little water to drink (if necessary). Emphasize the importance of mouth breathing o. Do not force the hose in. If there are obstacles or the client is choking, cyanotic, then stop pushing the tube. Check the position of the tube behind the throat using a tongue spatula and flashlight p. When you have finished installing the NGT to the specified end, encourage the client to relax and breathe normally q. Check the location of the hose by: 1) Attach the syringe to the end of the NGT, place the diaphragm part of the stethoscope on the client's left upper quadrant (gaster), then inject 10-20 cc of air along with abdominal auscultation 2) Aspirate slowly to obtain stomach contents 3) Insert the outer end of the NGT tube into a bowl filled with water. If there are air bubbles it means it has entered the lungs and if there are none it means it has entered the stomach.It is important to know the correct position before starting to insert food r. Apply alcohol to the tip of the client's nose and let it dry Helps stick the plaster better s. Fix the tube with plaster and avoid pressing on the nose: 1) Cut 10 cm of plaster, split it in half at one end 5 cm. Place the unsplit tip on the bridge of the client's nose and cross the tape over the tube coming out of the nose 2) Attach the tip of the NGT to the client's clothing by attaching tape to the tip and attaching it to the clothing t. Evaluate clients after having an NGT installed u. Tidy up the tools v. Washing hands w. Document the results of the action in the nursing notes