Friday, May 25, 2012

Naso Gastric Tube Procedure

Good morning all of you, my name is Made Udayati. I a Nursing Student in Wira Medika Institude Health Science and now i will explain to you about Naso Gastric Tube Procedure.
First, you must check nursing or medical note, and then assessment client needs naso gastric tube, after that, wash your hands before prepare equipment.
The equipment are :
-          Naso Gastric Tube, usually Levin (rubber or plastic, No. 12 to 18 French)
-          Water Soluble Lubricant
-          Suction equipment
-          Towel, tissue, emesis basin
-          Clam or tubing
-          Glass of water and straw or perhaps ice chips
-          Tincture of benzoin
-          Hypoallergenic tape
-          Irrigating set with 20 ml syringe or a 60 ml catheter-tip syringe
-          Stethoscope
-          Tongue blade or spatula
-          Pen light
-          Kidney dish
-          Disposable gloves
-          Decongestant spray
-          Lip pomade
-          Mouth hygiene materials

After you finish prepare equipment, and than communication with patient.
“good morning miss A, my name is nurse udayati. I will enter naso gastric tube in your nose. The goals of this proses are remove fliud and gas from the GI tract, prevent or relieve nausea and vomiting after surgery or traumatic events by decompressing the stomach, determine the mount of pressure and motor activity in the GI tract (diagnostic studies), administer medications and feeding directly into the GI tract, obtain a specimen of gastric contains for laboratory studies. Before I start, do you have any question?”
“have you ever had nasal surgery, traumatic or devinted septum?”

Explain procedure to the patient and tell how mouth breating and swallowing will help in passing the tube.
Place the patient in a sitting or high fowler’s position
Place a towel across her chest
And then speack with patient “if you gagging or discomfort, you can raise your index finger, to indicate wait a few moment”
Remove denture, place emesis basin and tissue within the patient’s reach
Determine the length of the tube needed to reach the stomach by placing the end of the tube at the tip of the patient’s nose, then extend it to the earlobe and down to the xiphoid process. Mark the distance with hypoallergenic tape
Have the patient blow her nose to clean her nostril
Inspect the nostril with a penlight, observing for any obstruction
Occlude each nostril and have the patient breathe, this will help determine which nostril is more patient
Wash your hands, and put on disposable gloves

Coil the first 7 – 10 cm of the tube around your fingers
Lubricate the coiled portion of the tube with water soluble lubricant. Avoid occluding the tube’s holes with lubricant
Tilt back the patient’s head before inserting tube in to nostril and gently pass tube into the posterior nasopharynx directing down ward and back ward toward the ear
When tube reaches the pharynx the patient may gage allow her to rest for a few moment
Have the patient hold her head in partially flexed position : offer her several sips of water sipped through a straw, unless contraindicated advance tube he the swallows
Continue to advance tube gently each time the patient swallows
If obstruction appears to prevent tube from passing do not use force. Rotating tube gently may help. If unsuccessful, remove tube and try other nostril
If there are signs of distress such as gasping, coughing or cyanosis, immediately remove tube
Continue to advance the tube when the patient swallows. Until the tape mark reaches the patient’s nostril
And finally check whether the Levin tube is in the stomach by :
1.      Aspirate contents of stomach with a 20 ml syringe or 50 ml. if stomach contents cannot be aspirated, place the patient on her left side and advance the tube 2,5 – 5 cm and try again
2.      Place a stethoscope over epigastrium, inject 5 – 15 ml of air into Levin tube
3.      Ask the patient to talk
4.      Use the tongue blade and penlight to examine the patient’s mouth
5.      If unsure whether the tube is in stomach, notify the physician
Apply tincture of benzoin to the area where the tape is placed.

Ok.. that it procedure Naso Gastric Tube, thanks you for your attention.


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