Assessment:
Check the physician’s orders. Assess the patient’s capabilities for cooperating with the procedure. Determine where the needed equipment is located.
Planning:
Wash your hands. Gather the equipment, as follows: Stethoscope, restraint or hand mitts (for infant or small children), asepto syringe, tongue balde, sterile disposable gloves, water soluble lubricant, tissues, glass of water with drinking, straw, kidney basin, nasogastric tube- appropriate size, adhesive tapes, safety pin and towel. Before insertinga nasogastric tube determine the size of tube to be inserted and whether or not the tube is to be attached to a suction. If it is necessary, plan for any assistance.
Implementation:
Identify the patient. Explain the procedure to the patient and why it is needed. Place the patient in high fowler’s position if possible. Put a clean towel over the patient’s chest to protect the linen. Prepare nose skin for tape. Put on gloves. Determine how far to insert the tube. Use the tube to mark off the distance from the tip of the client’s nose to the tip of the earlobe and then from the tip of the earlobe to the tip of the sternum. Mark the tube with a piece of tape. Lubricate the tube with a water-soluble lubricant. Lubricate the portion of the tube from tip to marking. Flex the patient’s head slightly forward. Have a basin in the patient’s lap and tissues handy. If orders allow, have the patient sip water and swallow while you gently but steadily advance the tube. There may be some temporary gagging, caused by the gag reflex, but this should subside as the tube is progressed. Using tape, secure the tube in the patient’s nose. Check to see if the end of the tube in the stomach. If it is curled in the back of the throat, it is uncomfortable and ineffective. You can easily check this by asking the patient to open the mouth or by holding down the tongue with a tongue depressor. Using a flashlight, you can see if the tube is curled in the back of the throat. You can check the tube’s position in several ways, some are more reliable than others. Keep the free end of the tube plugged at all times except when checking position, feeding, or irritating. Secure tubing’s using adhesive tapes. Coil free end and pin to the clothing. Help the patient to a comfortable position. Provide frequent oronasal care. Dispose of gloves, and wash your hands.
Evaluation:
Evaluate using the following criteria: Patient comfortable, No irritation at nostrils, Normal breathing rate and rhythm, No indications of nausea or regurgitation, Tube properly placed.
Documentation:
Initiate an intake and output patient record. Document the following on the patient record: Type and size of the tube inserted, Amount and characteristics of any drainage returned. Patient response to the procedure. Add to the Nursing care plan information pertinent to care needed.
