Nursing Skill Check: NG Tube Placement

Nursing skills lab procedure for inserting Nasogastric (NG) tube.

West Coast University students, you can find the Skills Checklist and Reference Guide links below:

“Nasogastric Tube Insertion: Before beginning this procedure, always perform the following steps to ensure patient safety. Wash hands / CDC guidelines, introduce yourself, use two patient identifiers,
verify allergy status. Materials Needed for Tube Insertion: Lopez valve, cup of water and straw, suction tubing, specimen cup, stethoscope, water-soluble lubricant, absorbent pad or towel, pen light, tongue blade, pH strips, tape, ng strip, irrigation tray, piston syringe, and needle gastric tube. The Procedure: Perform a GI assessment, assessing need for nasogastric tube placement, place patient and high Fowler’s position and cover chest with towel or chunks, explain the procedure and develop appropriate hand signal for patient, using a pen light, assess for any facial or nasal passage
issues contraindicated for this procedure. If suction is ordered, verify suction source at this time.
Connect suction tube to source of negative pressure setting control / physicians order. Obtain the appropriate equipment for nasogastric tube placement. Measure from the tip of the Nair to the earlobe using the NG tube, then measure to the xiphoid process of the sternum. Mark the distance
on the tube with a piece of tape or marker. Lubricate first four inches of the tube with water-soluble lubricant. Ask patient to slightly flex the neck backward. Insert tube into Nair gently. Pull back tube slightly when patient starts to gag until gagging ceases. Ask patients to dip forehead forward. Give
water with straw (if applicable) or have patient dry swallow, if necessary. Advance the tube several inches at a time as the patient swallows. Advance the tube until the taped or marked point reaches the Nair. Pull back tube immediately if there are signs of respiratory distress. Secure nasogastric tube in place do not let go of the tube until secured. Verify placement of the tube. Aspirate stomach content to test PH. Collect gastric content. Test PH. Connect the distal end of the tube to suction, draining bag or adapter after placement is verified per evidence-based guidelines. Dispose of
soiled supplies. Ensure safe environment. Return bed to lowest height with brakes locked and appropriate side rails up, and call light and bell in reach. Wash hands for CDC guidelines.”
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