NASOGASTRIC TUBE

DEFINITION
●
A flexible tube made of
rubber/plastic/silicone that is passed
through the nose and down through
the nasopharynx and esophagus
into the stomach.
 MAIN PRINCIPLE

By inserting a nasogastric tube,

you are gaining access to the
stomach and its contents.
 PURPOSE

•
Delivery of food and/or medicine
•
Drainage of gastric contents /
Decompression of the stomach
•
Obtain specimen of the gastric
contents
 CONTRAINDICATIONS
●
Nasogastric tubes are contraindicated in the
presence of severe facial trauma
●
(cribriform plate disruption), due to the possibility
of inserting the tube intracranially. In this instance,
an orogastric tube may be inserted.
 COMPLICATIONS OF NGT
FEEDING
• Abdominal cramping
• Abdominal swelling
• Diarrhea
• Nausea
• Vomiting
• Regurgitation of food or medicine
NGT Insertion: Preparing the Tube
NGT Insertion: Preparing the Tube
NGT Insertion: Preparing the Tube
NGT Insertion: Preparing the Tube
NGT Insertion: Inserting the Tube
NGT Insertion: Inserting the Tube
NGT Insertion: Checking Tube
Placement
NGT Insertion: Checking Tube
Placement
NGT Insertion: Checking Tube
Placement
 NURSING CARE
●
Maintain and promote comfort.
- Ensure that the tube is securely anchored to
the patient’s nose and is pinned to the gown
- Mouth care
•
Never allow patient to lie completely flat.
•
Report abdominal pain, discomfort, or nausea,
or vomiting immediately. The drainage flow is
probably obstructed and the tube will need to
be irrigated.
 IMPORTANT REMINDERS
ALWAYS assess correct placement of the NG tube
prior to infusing any fluids or tube feeds as per agency
policy. Check location of external markings on the tube and
colour of the PH of fluid aspirated from the tube. Routine
evaluation will ensure the correct placement of the tube and
reduce the risk of aspiration. Do not instill air to test location
of tube.
●
Do not give the patient anything to eat or drink without
knowing that the patient has passed a swallowing
assessment.
●
If changing the gown or repositioning the patient, take
care not to pull on the NG tube. Remember to unpin the
tube from the gown and repin the tube.
 NURSING CARE
●
Administration of feeds
Elevate head during feedings and for at least
30 minutes afterwards.
Bring feeding to room temperature prior to
administration.
Give feeding slowly (250 ml in 20 minutes)
Flush with water (air in neonates) to prevent
tube from blocking.
Do not mix medications with feeding.
Foley Catheters
A Foley catheter is a thin, sterile tube inserted into
the bladder to drain urine. Because it can be left in
place in the bladder for a period of time, it is also
called an indwelling catheter.
A Foley catheter is used with many disorders,
procedures, or problems such as these:
●
Retention of urine leading to urinary hesitancy,
straining to urinate, decrease in size and force of
the urinary stream, interruption of urinary stream,
and sensation of incomplete emptying
●
Obstruction of the urethra by an anatomical
condition that makes it difficult for one to urinate:
prostate hypertrophy, prostate cancer, or
narrowing of the urethra
A Foley catheter is used with many
disorders, procedures, or problems such
as these:
●
Urine output monitoring in a critically ill or
injured person
●
Collection of a sterile urine specimen for
diagnostic purposes
●
Nerve-related bladder dysfunction, such
as after spinal trauma (A catheter can be
inserted regularly to assist with urination.)
●
Imaging study of the lower urinary tract
●
After surgery
 Product Selection
• Size
• Length
• Drainage System
• Material
• Volume
• Duration of catheterization
●
Female catheterization: The female urethra is
short compared to the male urethra. It is located
above the vagina in the pelvis. Insertion of the
catheter is facilitated by having the patient lie
down on his or her back with the buttocks at the
edge of the examination table. Adequate exposure
of the urethra is obtained by elevating and
supporting the legs by stirrups or placing them in
a frog-legged position. Finally, the labia are
separated to expose the urethra.
●
Male catheterization: The male urethra is long
compared to the female urethra. A catheter is
placed while lying down or in the frog-legged
position. If there is a foreskin, it is retracted to its
The doctor or medical assistant will insert the
Foley catheter in this manner:
●
The urethra and the surrounding areas are
cleaned with a cotton-ball dipped in antiseptic
solution. Beginning at the urethra, the cleansing is
performed in a circular motion, moving outward to the
surrounding areas.
●
A Foley catheter, lubricated with water-soluble
jelly, is inserted into the bladder through the urethra.
●
Once the catheter is passed, the balloon is in the
bladder. It is then slowly inflated with about 10cc of
water using a syringe. Inflating the balloon should not
be painful.
●
At this time, urine, if present in the bladder, should
Preparing for Insertion
Preparing for Insertion
Preparing for Insertion
Preparing for Insertion
Preparing for Insertion
Inserting the Catheter
Inserting the Catheter
Inserting the Catheter
Inserting the Catheter
Inserting the Catheter
Removal of the catheter and bag
●
The catheter balloon is deflated by inserting a
syringe into the catheter valve and pulling back on
the syringe.
●
The pressure in the balloon will cause the water to
flow into the syringe.
●
Once the balloon is empty, the Foley catheter can
be pulled out.
Removal of the catheter and bag
Removal of the catheter and bag
Removal of the catheter and bag
Removal of the catheter and bag
When Should You Call a Doctor for
Complications of a Inserted Foley
Catheter?
●
Any pink or red urine or bleeding
from the urethra
●
Symptoms do not go away
●
Symptoms of infection
Complications
●
Health Care Associated Urinary Tract Infection
●
Allergic Reaction
●
Urethra / Kidney Damage
●
Septicemia
MANAGING THE RISKS
●
The balloon can break while the catheter is being inserted.
●
In this case, the doctor will remove all the balloon fragments.
●
The balloon does not inflate after it is in place.
●
Usually the doctor will check the balloon inflation before inserting
the catheter into the urethra. If the balloon still does not inflate
after its placement into the bladder, the doctor will then insert
another Foley catheter.
●
Urine stops flowing into the bag.
●
Check for correct positioning of the catheter and bag or for
obstruction of urine flow within the catheter tube.
●
Urine flow is blocked.
●
Change the bag or the Foley catheter or both.
●
The urethra begins to bleed.
●
Make sure that the urine collection bag does not drag and pull on
the catheter.
●
Monitor the bleeding. Severe bleeding may require removal of the
catheter.
MANAGING THE
RISKS
●
Bladder spasms
●
Keep the urine collection
bag below the level of the
bladder. Make sure that
urine is flowing out of the
catheter into the urine
collection bag.
●
Medication can be
prescribed for bladder
spasms. (Anticholinergics,
antidepressants)
MANAGING THE RISKS
●
Infection
●
Always wash your hands before and after handling the catheter.
●
Clean the area around the catheter with twice a day using soap and
water. Dry with a clean towel afterward
●
Check for inflammation or signs of infection in the area around the
catheter. (E.g. pus or irritated, swollen, red, or tender skin.)
●
Do not apply powder or lotion to the skin around the catheter.
●
Disconnect the drainage bag as seldom as possible.
●
Drink sufficient liquid to produce at least two liters of urine daily
Lecturers:
Ma. Yrvanna Andrea Legaspina
Francess Dane Cobrado
Documentations:
Myka Klariz Canlas
Precious Angela Canchico
Logistics:
Marissa Vargas
Registration:
Marie Grace Arcallo
 Medication mangt

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Process – trancribing, preparation and
administration
IV test and Skin Test
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Compatibility, HAM, SALAD

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●
Tracheostomy care
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CTT
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Ngt
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FC
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Colostomy
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Penrose and JP drain
 IV access

Sites -assessment, complications

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