Upload
brandon0920
View
222
Download
0
Embed Size (px)
Citation preview
8/8/2019 NGT Insertion 2003
1/25
8/8/2019 NGT Insertion 2003
2/25
NGT inserted through nostril passing the
nasopharynx until the stomach.
8/8/2019 NGT Insertion 2003
3/25
8/8/2019 NGT Insertion 2003
4/25
1. ADMINISTER TUBE FEEDINGS &
MEDICATIONS in clients unable to eat by
mouth or at risk of aspiration GAVAGE gastric feeding
2. means of GASTRIC DECOMPRESSION To prevent gastric distention, nausea and
vomiting
8/8/2019 NGT Insertion 2003
5/25
3. Diagnostic purposes for gastric content
analysis
Introduction of radiographic contrast for GIT
4. To wash off the stomach of poisons or
overdose in medications. LAVAGE gastric irrigation
8/8/2019 NGT Insertion 2003
6/25
Severe midface injury
Recent nasal surgery
Coagulation abnormality Esophageal varices
8/8/2019 NGT Insertion 2003
7/25
Large or small bore tube
Guidewire or stylet
Solution basin with ice or warm water Hypoallergenic adhesive tape
Clean gloves
Water soluble lubricant
Facial tissues
Glass of water with straw
20-50 ml syringe with an adapter
8/8/2019 NGT Insertion 2003
8/25
8/8/2019 NGT Insertion 2003
9/25
8/8/2019 NGT Insertion 2003
10/25
Basin pH strip or Meter
Stethoscope Disposable Pad/Towel Clamp/Plug (Optional) Suction Apparatus
Gauze Square/Plastic Specimen Bag/Elastic band Safety Pin Feeding tube
8/8/2019 NGT Insertion 2003
11/25
1. Assist to assume a High Fowlers position,
with head supported on pillow if condition
permits 2. Explain procedure.
3. Handwashing; observe universal blood andbody fluid precaution
4. Provide privacy. Place disposablepad/towel across chest.
8/8/2019 NGT Insertion 2003
12/25
5. Assess clients nostrils.
Hyperextend the head, with the use of a flashlight
assess for tissue integrity of nares noting anyabrasions or irritations.
Check for obstructions or deformities by askingclient to breathe on one nostril at a time.
Select nostril with greater airflow.
8/8/2019 NGT Insertion 2003
13/25
6. Prepare the tube
place tube on ice for 5-10 min if rubber
Warm water for plastic tube until it becomessofter/flexible.
Use a stylet secured in position for small bore.
8/8/2019 NGT Insertion 2003
14/25
7. Determine how far to insert the tube.
Measure from the tip of the clients nose to th etip
of the earlobe to the tip of xiphoid process. Mark with tape if with no markings.
8/8/2019 NGT Insertion 2003
15/25
8/8/2019 NGT Insertion 2003
16/25
8. Insert the tube Don gloves
Lubricate tip Insert tube with its natural curve toward client in
hyperextension of the neck, gently advance towardnasopharynx.
Direct tube along floor of nostril, toward ear onthat side
Apply slight pressure in nasopharynx, tearing ofeyes may occur. Offer tissues prn.
8/8/2019 NGT Insertion 2003
17/25
8. Insert the tube Withdraw tube if with resistance, relubricate and
reinsert in the other nostril. Once it reaches the oropharynx, gagging may
happen.
Ask client to tilt head forward and encourage to
drink and swallow. IF gagging is encountered, stop passing the tube
momentarily, have client rest take a few breathsand sips of water.
8/8/2019 NGT Insertion 2003
18/25
8. Insert the tube]
Pass the tube 5-10 cm(2-4 in) with each swallow.
If gagging persists and the tube does not advance,withdraw it slightly, inspect the throat if tube iscoiled in mouth. Withdraw and reinsert again.
8/8/2019 NGT Insertion 2003
19/25
9. Check for correct placement.
Aspirate stomach contents, check for pH.
Auscultate air insufflation Place stethoscope over epigastrium after injecting
10-30ml air listen for whooshing sound
If placement is negative in the stomach, advancetube 5cm, repeat test.
If small bore is used, leave stylet in place untilposition is verified in Xray
8/8/2019 NGT Insertion 2003
20/25
8/8/2019 NGT Insertion 2003
21/25
10. Secure the tube by taping it to the bridge
of the nose.
Wipe skin with alcohol Cut 7.5 cm (3in), split it lengthwise at one end
leaving a 2.5 cm tab at the end
Place tape over the bridge of the nose, bring splitends under or around the tubing and back up overthe nose
8/8/2019 NGT Insertion 2003
22/25
11. Attach tube to suction or feeding
apparatus, or clamp the end of tubing.
It may be covered with a gauze or plasticspecimen bag and an elastic band.
12. Secure the tube to clients gown with an elasticband and a safety pin. Or adhesive tape to the
tube.
8/8/2019 NGT Insertion 2003
23/25
1. Inspect nostril for discharge and irritation.
2. Clean nostril and tube with moistened
cotton-tipped applicators. 3. Apply water soluble lubricant if appears
dry.
4. Change adhesive tape prn.
5. Frequent mouth care.
8/8/2019 NGT Insertion 2003
24/25
Irrigate with 30ml normal saline at regular
intervals, irrigations require order from
doctor. Document clients input & output, as well as
amount and characteristic of drainage.
Note clients comfort and tolerance to
procedure.
Chart date, time of insertion, means by which
placement was checked and clients response.
8/8/2019 NGT Insertion 2003
25/25