Full Answer Section

3. Clinical Situations for NG Tube Orders:

• Bowel obstruction or ileus (paralysis of intestinal movement)
• Gastric feeding difficulties (dysphagia, nausea, vomiting)
• Pre- or post-surgery gut decompression
• Removal of gastric contents for diagnostic purposes

4. Questioning NG Tube Orders:

• Consider alternative feeding methods if appropriate.
• Check if tube placement is truly necessary for the specific condition.
• Ensure other interventions (medications, postural drainage) have been attempted if indicated.

5. NPO (Nothing by Mouth):

NPO means the patient should not eat or drink anything by mouth. This ensures the stomach is empty for procedures or to prevent aspiration risk.

6. Verifying NG Tube Placement:

The standard evidence-based practice is using three methods:

• X-ray confirmation: Most reliable method, visualizing tube position in the stomach.
• Auscultation (listening): Injecting air and listening for gurgling sounds over the stomach indicates correct placement.
• Aspirating gastric contents: Obtaining greenish bile confirms stomach position, while clear fluid suggests esophageal placement.

7. Pre-Insertion Assessments:

• Measure tube length: From bridge of nose to earlobe, to xiphoid process (tip of breastbone), add 6 inches.
• Assess nasal patency: Check for obstructions in both nostrils to ensure smooth passage.

8. Three Points for Length Measurement:

1. Bridge of nose
2. Earlobe
3. Xiphoid process (tip of breastbone)

9. Client Positioning:

• Semi-Fowler’s position (head and chest elevated) promotes ease of insertion and swallowing.

10. Patient Instructions:

• Swallow sips of water as the tube is advanced to help ease insertion.

11. Tube Securement:

• Use a commercial tube stabilization device to prevent accidental dislodgement.

12. Documentation:

• Record tube length inserted, placement verification method, and any complications.

13. NG Tube Removal Instruction:

• Inhale deeply and hold your breath, preventing air insufflation into the stomach.

14. Sterility/Asepsis:

• NG tube placement and removal require standard precautions but not full sterile technique.

15. Common Complication with Low Intermittent Suction:

• Electrolyte imbalance due to excessive removal of stomach contents, particularly potassium.

I hope this information clarifies your questions about NG tube placement and management. Remember, these are general guidelines, and specific protocols may vary depending on the healthcare facility and patient context. Always consult with a qualified healthcare professional for specific instructions and safety procedures.