Inserting a Nasogastric Tube Goal: The tube is passed into the patients stomach without any complications.

NURSING ACTION 1. Check physicians o de !o inse tion o! N" tube and conside the isks associated with N" tube inse tion. #. Identi!y the patient.

RATIONALE This cla i;es p ocedu e and type o! e(uipment e(ui ed. < onchial intubation is a possible complication. I denti;cation o! the patient ensu es that the i*ht patient ecei&es the co ect tube !eedin* as o de ed. E%planation !acilitates patient coope ation. =ome patientsu &eys epo t that o! all outine p ocedu es8 the inse tiono! a N" tube is conside ed the most pain!ul. Lidocaine*el o sp ays a e possible options to dec ease discom!o tdu in* N" tube inse tion. This p o&ides !o o *ani>ed app oach to task. N" tubes should be adio7opa(ue8 contain clea ly &isible ma kin*s !o measu ement8 and ha&e multiple po ts !o aspi ation. /and hy*iene dete s the sp ead o! mic oo *anisms. Closin* cu tains o doo p o&ides !o patient p i&acy. Raisin* the bed p omotes the com!o t and p ope body mechanics o! the nu se. ?p i*ht position is mo e natu al !o swallowin* and p otects a*ainst b onchial intubation aspi ation8 i! the patient should &omit. ,assa*e o! tube may stimulate *a**in* and tea in* o! eyes. 1easu ement ensu es that tube will be lon* enou*h to ente patients stomach.

$. E%plain the p ocedu e to the patient and p o&ide the ationale as to why the tube is needed. 'iscuss the associated discom!o ts that may be e%pe ienced and possible inte &entions that may allay this discom!o t. Answe any (uestions as needed. ). "athe e(uipment includin* selection o! the app op iate N" polyu ethane tube.

+. ,e !o m hand hy*iene. ,ut on nonste ile *lo&es. -. Close the patients bedside cu tain o doo . Raise the bed. Assist the patient to hi*h .owle s position and ele&ate the head o! the bed )+ de* ees. ' ape chest with bath towel o disposable pad. /a&e emesis basin and tissues handy.

0. Measure the distance to insert tube by placing tip of tube at patient s nostril and e!tending to tip of ear lobe and then to tip of !iphoid process" 1a k tube with an indelible ma ke . 2. Lub icate tip o! tube 3at least #45)46 with wate 7soluble lub icant. Apply topical anesthetic to nost il and o opha yn%8 as app op iate.

Lub ication educes ! iction and !acilitates passa*e o! thetube into stomach. @ate 7 soluble lub icant will not causepneumonia i! tube accidentally ente s the lun*s. Topicalanesthetics act as local anesthetics8 educin* discom!o t.Consult the physician !o an o de !o a topical anestheticsuch as lidocaine *el o sp ay i! needed.

9. A!te selectin* the app op iate nost il8 ask patient to sli*htly !le% head back a*ainst the pillow. "ently inse t the tube into the nost il while di ectin* the tube upwa d and backwa d alon* the !loo o! the nose. ,atient may *a* when tube eaches pha yn%. , o&ide tissues !o tea in* o wate in* o! eyes. O!!e com!o t and eassu ance to the patient.

.ollowin* the no mal contou o! the nasal passa*e while inse tin* the tube educes i itation and the likelihood o! mucosal inAu y. The *a* eBe% is eadily stimulated by the tube. Tea s a e a natu al esponse as the tube passes into the nasopha yn%. 1any patients epo t that *a**in* and th oat discom!o t can be mo e pain!ul then passin* th ou*h the nost ils. Lub ication educes ! iction and !acilitates passa*e o! the tube into stomach. @ate 7

1:. #hen pharyn! is reached$ instruct