SABINO,RAZHIEL J. PROF.
PRECY LANTIN
BSN - 3F / GROUP 2 NCM 116 - RLE
RATIONALIZATION OF NGT
NGT INSERTION
1 Checks physician's order for insertion of
nasogastric tube.
2 Identifies and explains procedures to
patient.
3 Gathers Equipment
4 Performs hand hygiene. Don appropriate
PPE.
5 Assists patient to Fowler's position if
tolerated.
Drape chest with bath towel or disposable
pad.
Have emesis basin and tissue paper on
hand.
6 Checks nares for patency.
a. For conscious client, asks client to
occlude one nostril and breath normally
through the other. Select nostril through
which air passes more easily.
b. For unconscious client, checks nostril
patency using penlight.
7 Assesses bowel sound
8 Measures distance by placing tip of tube at
patient's nostril and extending to tip of
earlobe and then to the xiphoid process.
Mark tube with a piece of tape if no
calibration.
9 Lubricates the tip of tube (at least 1-2
inches) with water soluble lubricant.
10 After lifting the head of the client insert tube
into the nostril while directing tube
downward and backward. Patient may gag
when tube reaches the pharynx.
11 Tilts the client head forward. Once the tube
reaches the throat, encourage the client to
swallow. Advance the tube 5-10 cm on
each swallow. Keep advancing tube util
marking is reach. If gaggling and coughing
persist, check the mouth for the placement
of tube with the tongue blade and penlight.
12 Discontinues the procedure and removes
tube if there are signs of distress (gasping,
coughing, cyanosis, ability to speak or
hum).
13 Secures tube properly.
a. Cut a 5-inch leucoplast and split bottom
3 inches.
b. Places unsplit end over bridge on the
client's nose.
c. Wraps split ends under tubing and up
and over into the nose.
14 Checks the tube if it is in patient's stomach.
a. Introduce 10-30ml of air into the tube
and auscultate at the epigastric area, note
gurgling sound.
b. Aspirates stomach contents and checks
the pH (1.5-4)
15 Clamps the tube and cap it.
16 Secures the tube to patient's gown at the
shoulder level by using a tape.
17 Performs hand hygiene. Removes all
equipment and make client comfortable.
18 Records the type, size, and tube calibration
marking. Documents description of gastric
content.
NGT FEEDING
1 Verifies doctors order for the feeding.
2 Prepares the tube feeding at room
temperature.
3 Obtains the materials needed such as:
a. Type and amount of enteral feeding.
b. Stethoscope
C. Asepto syringe
d. Sterile gloves
e. Calibrated glass with 30 cc of water
4 Identifies and explain procedure to the
client and/or significant others.
5 Places the client on Fowler's position.
6 Assesses the bowel sound
7 Observes insertion site for irritation and
signs of infection.
Checks for the tube placement and
patency.
8 a. Introduces 10-30 ml of air into the tube
and auscultates the epigastric area and
notes gurgling sound.
9 b. Aspirates stomach contents and checks
the pH.
10 c. Assesses the residual gastric contents
for the amount, color, and presence of
blood and refer accordingly.
Infuses feeding.
11 a. Pinches proximal end of the tube.
12 b. Attaches asepto syringe to the tube and
aspirate gastric content.
13 c. Removes the bulb and fills the syringe
with measured amount of formula
14 d. Releases the tube and holds the syringe
at 12 inches above the nares.
15 e. Refills and repeats the process until the
prescribed amount has been given.
16 Instills 30 ml of water into the tube.
17 Clamps the tube before all water is instilled.
18 Secures the tubing to the client's gown at
the shoulder level.
19 Maintains client in fowler's position for 30
minutes after feeding
20 Does aftercare and handwashing.
21 Evaluates client's tolerance and response
to feeding.
22 Documents the procedure.
a. Record the amount, type, and time of
feeding.
REMOVAL OF NGT
1 Verifies doctor's order for removal of NGT.
2 Prepares all materials needed:
a. Towel/pad
b. Gloves
c. Kidney basin
d. Cotton ball wet with NSS
3 Washes hands
4 Identifies, informs, and explains the
procedure to the client.
5 Assists client to Fowler's position.
6 Places the towel/pad across the client's
chest.
7 Unpins the tube to the client's gown.
8 Moistens leucoplast to the client's nose
using cotton balls wet with NSS and
remove gently.
9 Wears gloves and asks the client to take a
deep breath and hold it.
10 Pinches the tube with glove hand then
quickly and smoothly withdraw the tube.
11 Provides oral and nasal care.
12 Documents the procedure
