Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

SKILL 11-2

Inserting a Nasogastric (NG) Tube (Continued)

Comments

10. When pharynx is reached, instruct patient to touch chin to
    chest. Encourage patient to sip water through a straw or
    swallow even if no fluids are permitted. Advance tube in
    downward and backward direction when patient swallows.
    Stop when patient breathes. If gagging and coughing per-
    sist, stop advancing the tube and check placement of
    tube with tongue blade and flashlight.If tube is curled,
    straighten the tube and attempt to advance again. Keep
    advancing tube until pen marking is reached. Do not use
    force. Rotate tube if it meets resistance.
    11.Discontinue procedure and remove tube if there are signs
    of distress, such as gasping, coughing, cyanosis, and
    inability to speak or hum.


11. Secure the tube loosely to the nose or cheek until it is
    determined that the tube is in the patient’s stomach:
    a. Attach syringe to end of tube and aspirate a small
    amount of stomach contents.
    b. Measure the pH of aspirated fluid using pH paper or a
    meter. Place a drop of gastric secretions onto pH paper
    or place small amount in plastic cup and dip the pH
    paper into it. Within 30 seconds, compare the color on
    the paper with the chart supplied by the manufacturer.
    c. Visualize aspirated contents, checking for color and
    consistency.
    d. Obtain radiograph (x-ray) of placement of tube, based
    on facility policy (and ordered by physician).


12. Apply skin barrier to tip and end of nose and allow to
    dry. Remove gloves and secure tube with a commercially
    prepared device (follow manufacturer’s directions) or tape
    to patient’s nose. To secure with tape:
    a. Cut a 4piece of tape and split bottom 2or use pack-
    aged nose tape for NG tubes.
    b. Place unsplit end over bridge of patient’s nose.
    c. Wrap split ends under tubing and up and over onto
    nose. Be careful not to pull tube too tightly against
    nose.


13. Put on gloves. Clamp tube and remove the syringe. Cap the
    tube or attach tube to suction according to the medical
    orders (see Chapter 13).

ExcellentSatisfactoryNeeds Practice

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